Armed spider bite - Revision history

Rossdonaldson1 at 13:08, 29 May 2022

2022-05-29T13:08:17Z

← Older revision		Revision as of 13:08, 29 May 2022
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	==Background<ref>Leslie V. Boyer, Greta J. Binford, Janice A. Degan. Spider Bites. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 1010-1011.</ref>==		==Background<ref>Leslie V. Boyer, Greta J. Binford, Janice A. Degan. Spider Bites. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 1010-1011.</ref>==
			[[File:p nigreventer.jpeg\|thumb\|Phoneutria nigreventer, The Brazilian Wandering Spider]]
	*Identification: Brown gray with white spots forming a longitudinal band on the dorsal abdomen and a red-brown brush of hair on the chelicerae. Large in size (4.5-6cm) with 4-5mm fangs.		*Identification: Brown gray with white spots forming a longitudinal band on the dorsal abdomen and a red-brown brush of hair on the chelicerae. Large in size (4.5-6cm) with 4-5mm fangs.
	**They do not form webs, but rather are mobile nocturnal hunters		**They do not form webs, but rather are mobile nocturnal hunters
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	*Genus: Phoneutria		*Genus: Phoneutria
	*The best-known representative is P. nigriventer, the Brazilian Wandering Spider		*The best-known representative is P. nigriventer, the Brazilian Wandering Spider
	~~[[File:p nigreventer.jpeg\|thumb\|Phoneutria nigreventer, The Brazilian Wandering Spider]]~~

	==Venom==		===Venom===
	*A complex mixture of polypeptide components. Neurotoxicity is the most clinically relevant.		*A complex mixture of polypeptide components. Neurotoxicity is the most clinically relevant.
	*Histamine and other components potentiate localized swelling and vascular permeability		*Histamine and other components potentiate localized swelling and vascular permeability

Rossdonaldson1: /* References */

2021-11-25T14:30:19Z

References

← Older revision		Revision as of 14:30, 25 November 2021
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	==References==		==References==
	<references/>		<references/>

			[[Category:Environmental]]
			[[Category:Dermatology]]

ClaireLewis at 21:20, 25 August 2021

2021-08-25T21:20:37Z

← Older revision		Revision as of 21:20, 25 August 2021
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	*Initial intense pain that radiates to the trunk		*Initial intense pain that radiates to the trunk
	*Within 10-20 minutes, onset of systemic toxicity		*Within 10-20 minutes, onset of systemic toxicity
	**Tachycardia		**[[Tachycardia]]
	**Hypertension		**[[Hypertension]]
	**Profuse diaphoresis,		**Profuse diaphoresis,
	**Salivation		**Salivation
	**Vertigo		**[[Vertigo]]
	**~~Vision~~ disturbances		**[[Visual disturbances]]
	**Nausea and ~~Vomiting~~		**[[Nausea and vomiting]]
	**Priapism		**[[Priapism]]
	*Death has been reported, particularly in children and frail adults, from respiratory paralysis		*Death has been reported, particularly in children and frail adults, from respiratory paralysis
	*Most recover in 24-48hours		*Most recover in 24-48hours
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	==Management==		==Management==
	*Largely Supportive Care		*Largely Supportive Care
	**Pain Control		**[[Pain Control]]
	***Local anesthetic infiltration at site of the bite is effective in 95% of cases		***[[Local anesthetic]] infiltration at site of the bite is effective in 95% of cases
	***~~Opiates~~ are discouraged as they may potentiate respiratory depression in severe envenomation		***[[Opioids]] are discouraged as they may potentiate respiratory depression in severe envenomation
	*Antivenom		*Antivenom
	**Polyvalent and Monovalent formulations available		**Polyvalent and Monovalent formulations available
	***Skin testing and antihistamine ~~ppx~~ recommended prior to use		***Skin testing and antihistamine prophylaxis recommended prior to use
	***1-5 vials given IV or IM		***1-5 vials given IV or IM
	**Clinical response judged by relief of pain or resolution of priapism		**Clinical response judged by relief of pain or resolution of priapism

Athorne at 02:04, 2 August 2021

2021-08-02T02:04:39Z

← Older revision		Revision as of 02:04, 2 August 2021
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	==Background==<ref>Leslie V. Boyer, Greta J. Binford, Janice A. Degan. Spider Bites. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 1010-1011.</ref>		==Background<ref>Leslie V. Boyer, Greta J. Binford, Janice A. Degan. Spider Bites. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 1010-1011.</ref>==
	*Identification: Brown gray with white spots forming a longitudinal band on the dorsal abdomen and a red-brown brush of hair on the chelicerae. Large in size (4.5-6cm) with 4-5mm fangs.		*Identification: Brown gray with white spots forming a longitudinal band on the dorsal abdomen and a red-brown brush of hair on the chelicerae. Large in size (4.5-6cm) with 4-5mm fangs.
	**They do not form webs, but rather are mobile nocturnal hunters		**They do not form webs, but rather are mobile nocturnal hunters
Line 5:		Line 5:
	*Genus: Phoneutria		*Genus: Phoneutria
	*The best-known representative is P. nigriventer, the Brazilian Wandering Spider		*The best-known representative is P. nigriventer, the Brazilian Wandering Spider
			[[File:p nigreventer.jpeg\|thumb\|Phoneutria nigreventer, The Brazilian Wandering Spider]]

	==Venom==		==Venom==

Athorne: /* External Links */

2021-08-02T01:59:15Z

External Links

← Older revision		Revision as of 01:59, 2 August 2021
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	==See Also==		==See Also==
	*[[Envenomations, bites and stings]]		*[[Envenomations, bites and stings]]

	~~==External Links==~~


	==References==		==References==
	<references/>		<references/>

Athorne: /* Background */

2021-08-02T01:58:35Z

Background

← Older revision		Revision as of 01:58, 2 August 2021
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	==Background==		==Background==<ref>Leslie V. Boyer, Greta J. Binford, Janice A. Degan. Spider Bites. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 1010-1011.</ref>
	*Identification: Brown gray with white spots forming a longitudinal band on the dorsal abdomen and a red-brown brush of hair on the chelicerae. Large in size (4.5-6cm) with 4-5mm fangs.		*Identification: Brown gray with white spots forming a longitudinal band on the dorsal abdomen and a red-brown brush of hair on the chelicerae. Large in size (4.5-6cm) with 4-5mm fangs.
	**They do not form webs, but rather are mobile nocturnal hunters		**They do not form webs, but rather are mobile nocturnal hunters

Athorne: /* Disposition */

2021-08-02T01:57:34Z

Disposition

← Older revision		Revision as of 01:57, 2 August 2021
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	==Disposition==		==Disposition==
			*May discharge those with no systemic symptoms after period of ED observation
			*Admit patients with signs or symptoms of systemic toxicity

	==See Also==		==See Also==

Athorne: /* Management */

2021-08-02T01:56:25Z

Management

← Older revision		Revision as of 01:56, 2 August 2021
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	==Management==		==Management==
			*Largely Supportive Care
			**Pain Control
			***Local anesthetic infiltration at site of the bite is effective in 95% of cases
			***Opiates are discouraged as they may potentiate respiratory depression in severe envenomation
			*Antivenom
			**Polyvalent and Monovalent formulations available
			***Skin testing and antihistamine ppx recommended prior to use
			***1-5 vials given IV or IM
			**Clinical response judged by relief of pain or resolution of priapism

	==Disposition==		==Disposition==

Athorne: /* Evaluation */

2021-08-02T01:50:52Z

Evaluation

← Older revision		Revision as of 01:50, 2 August 2021
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	==Evaluation==		==Evaluation==
	~~===Workup===~~		*Generally a clinical diagnosis

	~~===Diagnosis===~~

	==Management==		==Management==

Athorne: /* Clinical Features */

2021-08-02T01:50:03Z

Clinical Features

← Older revision		Revision as of 01:50, 2 August 2021
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	==Clinical Features==		==Clinical Features==
			*Initial intense pain that radiates to the trunk
			*Within 10-20 minutes, onset of systemic toxicity
			**Tachycardia
			**Hypertension
			**Profuse diaphoresis,
			**Salivation
			**Vertigo
			**Vision disturbances
			**Nausea and Vomiting
			**Priapism
			*Death has been reported, particularly in children and frail adults, from respiratory paralysis
			*Most recover in 24-48hours

	==Differential Diagnosis==		==Differential Diagnosis==