Spider bite is common, but most species cause minimal or no
effects. Patients may be misinformed regarding the nature and
consequences of a bite. Understanding the current literature can
assist the physician in the management of spider bite patients.
This article reviews the current literature on spider bites and
describes the clinical assessment and management of the
medically important spider bites.
Most spider bite is minor and causes nothing more than
local irritation. Some spiders can cause significant morbidity
and rarely, mortality. Lay identification of the spider has not
been shown to be reliable. Latrodectism (red back spider
envenomation) is characterised by pain (local, radiating, and
regional); systemic symptoms occur less commonly. Funnel web
spider bite is a medical emergency; a pressure immobilisation
bandage should be applied and the patient transferred to a
hospital with available antivenom and resuscitation facilities.
Clinicians must consider spider bite in the differential diagnosis
of unexplained autonomic and neurological dysfunction,
particularly in children. In Australia, skin ulceration is more likely
to be an infective, inflammatory or traumatic cause than a case
of necrotising arachnidism.
We live in a world full of spiders. Of the 40 000 species that have been identified there are probably four times as many that have not been classified.1 In Australia, spiders are the most widely distributed venomous creatures with an estimated 10 000 species.2
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