View source for Spider bites

==Background==
*Standard [[abscess]] are not typically due to spider bites and should not be diagnosed as such

===Clinically important spider genera by geographic region=== 
* North America  
** Loxosceles (e.g. [[brown recluse]])
** Latrodectus (e.g. [[black widow]])
** Tegenaria 
* South America 
** Loxosceles 
** Latrodectus 
** [[Phoneutria]] (e.g. [[armed spider]])
* Africa 
** Loxosceles 
** Latrodectus 
* Europe 
** Loxosceles 
** Latrodectus 
* Australia 
** Atrax (e.g. [[funnel-web spider]])
** Hadronyche (e.g. [[funnel-web spider]])
** Latrodectus  
* Asia 
** Latrodectus 
*Other
**[[Tarantula spider bite]]

===Visual Spider Identification===
<gallery mode="packed">
File:Tarantula640px-Brachypelma smithi 2009 G03.jpg|[[Tarantula]]
File:Western Black Widow (Latrodectus hesperus).jpg|[[Black widow spider]]
File:Brown Recluse.jpg|[[Brown recluse]]
File:p nigreventer.jpeg|[[Armed spider]] (''phoneutria nigreventer'')
File:Funnel Web Spider.png|[[Funnel-web spider]] (Hadronyche versuta)
</gallery>

==Clinical Features==
===History=== 
* Determine circumstances of bite to assess consistency with spider habitat and behavior     
** Indoors vs outdoors 
** Day vs night  
** Geographic location (recent travel)
* Appearance of the spider if seen 
* Dead spiders can be preserved in 70% EtOH and later identified by arachnologists or entomologist 

===Physical Exam===
* No pathognomonic signs proving lesion is a spider bite 
* Assess both bite site and for systemic signs
* Bite Site
** Location
*** Spider bites more common when clothing is tight against skin
** Number of bites
*** Multiple bites suggest parasitic insect and not spider 
** Appearance of bite 
*** Erythema, pallor, hemorrhage, induration, tenderness, paresthesia, vesicles
* Systemic findings
** Abnormal vital signs ([[tachycardia]] possible with black widow)
** [[Altered mental status]]
** [[Abdominal pain]]
** Diaphoresis 
** Generalized [[rash]]
** Muscle fasciculations, spasm, or tenderness

==Differential Diagnosis==
{{Bites and stings DDX}}

==Evaluation==
===Workup===

===Diagnosis===
*Typically a clinical diagnosis

==Management==
* Clean area of bite 
* [[Tetanus prophylaxis]] 
* [[analgesia|Analgesics]] 
* Hydration 
* Surgical follow up if indicated for debridement of necrotic area  
* [[Antivenin]] is indicated only for specific envenomation 
* No proven benefit for [[corticosteroids]] 
* No indication for antibiotics unless concern for [[cellulitis]] 

==Disposition==


==See Also==
*[[Bites and Stings]]

==External Links==


==References==
<references/>
* Boyer LV, Binford GJ, Degan JA. Spider Bites. In Auerbach PS, Cushing TA, Harris NS. Auerbach’s Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017: 993-1016.

[[Category:Environmental]]
[[Category:Toxicology]]