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Spider Envenomation, Widow: Differential Diagnoses & Workup
Updated: Jul 24, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Workup
Laboratory Studies
- If the diagnosis is uncertain, laboratory studies to rule out alternative diagnoses (eg, acute abdomen, myocardial infarction) (eg, CBC, pregnancy test, cardiac markers).
- The serum creatine kinase (CK) and peripheral white blood cell count may be elevated.
Imaging Studies
- Consider performing an acute abdominal series or an abdominal CT scan if the diagnosis is unclear in a patient presenting with abdominal pain.
Other Tests
- Skin testing variably may predict immediate hypersensitivity to antivenom and may influence the decision regarding its administration. Antivenom-induced anaphylaxis may be more life threatening than the envenomation itself.
- Obtain an ECG, if indicated (eg, comorbidity, chest pain, severe hypertension).
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References
Allen RC, Norris RL. Delayed use of widow spider antivenin. Ann Emerg Med. Sep 1995;26(3):393-4. [Medline].
Boyer Hassen LV, McNally JT, Binford GJ. Spider bites. In: Auerbach PS, ed. Wilderness Medicine. 4th ed. St. Louis: Mosby-Year Book; 2001:807-838.
Bush SP, Thomas TL, Chin ES. Envenomations in children. Pediatr Emerg Med Rep. 1997;2:1-12.
Bush SP, Naftel J. Injection of a whole black widow spider. Ann Emerg Med. Apr 1996;27(4):532-3. [Medline].
Bush SP. Black widow spider envenomation mimicking cholecystitis. Am J Emerg Med. May 1999;17(3):315. [Medline].
Clark RF, Wethern-Kestner S, Vance MV, Gerkin R. Clinical presentation and treatment of black widow spider envenomation: a review of 163 cases. Ann Emerg Med. Jul 1992;21(7):782-7. [Medline].
Cohen J, Bush S. Case report: compartment syndrome after a suspected black widow spider bite. Ann Emerg Med. Apr 2005;45(4):414-6. [Medline].
Gonzalez Valverde FM, Gomez Ramos MJ, Menarguez Pina F, Vazquez Rojas JL. [Fatal latrodectism in an elderly man]. Med Clin (Barc). Sep 22 2001;117(8):319. [Medline].
Langley RL, Morrow WE. Deaths resulting from animal attacks in the United States. Wild Environ Med. 1997;8:8-16.
Pneumatikos IA, Galiatsou E, Goe D, Kitsakos A, Nakos G, Vougiouklakis TG. Acute fatal toxic myocarditis after black widow spider envenomation. Ann Emerg Med. Jan 2003;41(1):158. [Medline].
Watson WA, Litovitz TL, Klein-Schwartz W, Rodgers GC Jr, Youniss J, Reid N, et al. 2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 2004;22(5):335-404. [Medline].
Woestman R, Perkin R, Van Stralen D. The black widow: is she deadly to children?. Pediatr Emerg Care. Oct 1996;12(5):360-4. [Medline].
Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). Dec 2007;45(8):815-917. [Medline].
Hoxha R. Two Albanians die from black widow spider bites. BMJ. Aug 5 2006;333(7562):278. [Medline].
Further Reading
Keywords
black widow spider, spider bite, black widow spider bite, spider envenomation, Latrodectus, Latrodectus mactans mactans, brown widow, Latrodectus geometricus, red-legged widow, Latrodectus bishopi, redback spider, Latrodectus hasselti, button spider, Latrodectus indistinctus, Latrodectus variolus, Latrodectus hesperus, Latrodectus mactans tredecimguttatus, Latrodectus pallidus
Differential Diagnoses & Workup: Spider Envenomation, Widow