eMedicine Specialties > Ophthalmology > Unclassified Disorders

Spider Bites

Author: Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Contributor Information and Disclosures

Updated: Jun 19, 2009

Introduction

Background

Bites of spiders belonging to the genera Latrodectus, Phoneutria, and Loxosceles can cause severe, even fatal, systemic poisoning in humans. The most numerous of the venomous spiders are of the genus Latrodectus.

Pathophysiology

The venom of spiders in the genus Latrodectus (which includes the American black widow spider) and in members of the genus Phoneutria is a nonhemolytic, noncytotoxic neurotoxin that produces diffuse central and peripheral nervous excitement, autonomic activity, muscle spasm, hypertension, and vasoconstriction in humans. Other symptoms may include abdominal rigidity, intense pain, paresthesia, headache, sweating, nausea, and facial blood vessel congestion.1

The venom of spiders of the Loxosceles genus (which includes the brown recluse spider) is a mixture of hemolysin and cytotoxin that causes ischemic necrosis at the site of the bite.2,3,4 The bite is often relatively painless, and the lesion is initially surrounded by a bluish-white halo of vasoconstriction that may later develop extensive gangrene. Tarantulas, or wolf spiders, of various genera, including Lycosa and Phidippus, also may cause necrosis and ulceration in humans.5,6

The ocular effects of these spiders' venom include edema, gangrene, necrosis, ptosis, and purpura of the lid; conjunctivitis; subconjunctival hemorrhages; pupil constriction; retinal cyanosis; and visual disturbances.

Frequency

United States

Infrequent

Mortality/Morbidity

The genera Latrodectus, Phoneutria, and Loxosceles can cause severe, even fatal, systemic poisoning in humans.

Sex

Spider bites are more frequent in males than in females.

Age

Spider bites are most frequent among persons aged 10-30 years.

Clinical

History

Patients may report a history of an insect bite while moving wood or working in dark areas.

Physical

Usually, a white area appears around the lesion. The genera Latrodectus, Phoneutria, or Loxosceles may cause systemic reactions.

Causes

See Pathophysiology.

More on Spider Bites

Overview: Spider Bites
Differential Diagnoses & Workup: Spider Bites
Treatment & Medication: Spider Bites
Follow-up: Spider Bites
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Goddard J, Upshaw S, Held D, Johnnson K. Severe reaction from envenomation by the brown widow spider, Latrodectus geometricus (Araneae: Theridiidae). South Med J. Dec 2008;101(12):1269-70. [Medline].

  2. Portilla Cuenca J, Maresca Quintero M, Hoyos Sanabria B, Garcia Benito JI, Velez Medina J, et al. Spider's bite that develop eyelid necrosis. Arch Soc Esp Oftalmol. Feb 2005;80(2):105-7. [Medline].

  3. Felicori L, Fernandes PB, Giusta MS, Duarte CG, Kalapothakis E, Nguyen C, et al. An in vivo protective response against toxic effects of the dermonecrotic protein from Loxoscelesintermedia spider venom elicited by synthetic epitopes. Vaccine. May 1 2009;[Medline].

  4. Vetter RS. The distribution of brown recluse spiders in the southeastern quadrant of the United States in relation to loxoscelism diagnoses. South Med J. May 2009;102(5):518-22. [Medline].

  5. Naidu DK, Ghurani R, Salas RE, Mannari RJ, Robson MC, Payne WG. Osteomyelitis of the mandibular symphysis caused by brown recluse spider bite. Eplasty. Aug 28 2008;8:e45. [Medline].

  6. Bucaretchi F, Mello SM, Vieira RJ, Mamoni RL, Blotta MH, Antunes E, et al. Systemic envenomation caused by the wandering spider Phoneutria nigriventer, with quantification of circulating venom. Clin Toxicol (Phila). Nov 2008;46(9):885-9. [Medline].

  7. Cole HP 3rd, Wesley RE, King LE Jr. Brown recluse spider envenomation of the eyelid: an animal model. Ophthal Plast Reconstr Surg. Sep 1995;11(3):153-64. [Medline].

  8. Edwards JJ, Anderson RL, Wood JR. Loxoscelism of the eyelids. Arch Ophthalmol. Nov 1980;98(11):1997-2000. [Medline].

  9. Jarvis RM, Neufeld MV, Westfall CT. Brown recluse spider bite to the eyelid. Ophthalmology. Aug 2000;107(8):1492-6. [Medline].

  10. Kelly TD, deHaro L. The dangers of pet tarantulas: experience of the Marseilles Poison Centre. J Toxicol Clin Toxicol. 1998;36:55-6.

  11. Wilson DC, King LE. Spiders and spider bites. Dermatol Clin. 1990;8:277-286. [Medline].

  12. Zeligowski AA, Peled IJ, Wexler MR. Eyelid necrosis after spider bite. Am J Ophthalmol. Feb 15 1986;101(2):254-5. [Medline].

[ CLOSE WINDOW ]

Keywords

spider bites, spiders, brown recluse spider, black widow spider, venomous spiders, spider venom, poisoning

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Kilbourn Gordon III, MD, FACEP, Urgent Care Physician
Kilbourn Gordon III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

James P Gills, MD, Founder, St Luke's Cataract and Laser Institute; Professor, Department of Ophthalmology, University of South Florida College of Medicine
James P Gills, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.