Black widow spider bite: Difference between revisions

Revision as of 21:01, 25 September 2015

Black widow spider

Envenomation causes release of acetylcholine and norepinephrine from the nerve terminals causing muscle cramps, tachycardia and hypertension

Pinprick sensation; then increasing local pain that may spread to entire extremity
Erythema appears 20-60 min after the bite
Pain begins to abate after several hours and disappears by 2-3d

Muscle cramp-like spasms in large muscle groups (although exam rarely reveals rigidity)
Pain becomes generalized
- Severe abdominal wall musculature pain and cramping
HA, n/v, diaphoresis, photophobia, dyspnea
A-fib, myocarditis, priapism, and death are rare

Consider admission for:
- Symptoms of moderate envenomation
- Pregnant women
- Children
- Pts w/ preexisting cardiovascular disease or HTN

Authors:

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 ==Clinical Features==
-*Local
+===Local===
-**Pinprick sensation; then increasing local pain that may spread to entire extremity
+*Pinprick sensation; then increasing local pain that may spread to entire extremity
-**Erythema appears 20-60 min after the bite
+*Erythema appears 20-60 min after the bite
-**Pain begins to abate after several hours and disappears by 2-3d
+*Pain begins to abate after several hours and disappears by 2-3d
-*Systemic
-**Muscle cramp-like spasms in large muscle groups (although exam rarely reveals rigidity)
+===Systemic===
-**Pain becomes generalized
+*Muscle cramp-like spasms in large muscle groups (although exam rarely reveals rigidity)
-***Severe abdominal wall musculature pain and cramping
+*Pain becomes generalized
-**HA, n/v, diaphoresis, photophobia, dyspnea
+**Severe abdominal wall musculature pain and cramping
-**A-fib, myocarditis, priapism, and death are rare
+*HA, n/v, diaphoresis, photophobia, dyspnea
+*A-fib, myocarditis, priapism, and death are rare
 ==Differential Diagnosis==