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Tarantula Envenomation Treatment & Management

  • Author: Scott D Fell, DO, FAAEM; Chief Editor: Joe Alcock, MD, MS  more...
Updated: Oct 01, 2013

Prehospital Care

Capture the offending arachnid for identification if it is possible to do so safely.

Begin supportive therapy for patients who are having a rare allergic reaction or anaphylaxis.

Following ocular exposure, place a protective shield over the eyes to prevent the patient from rubbing the eyes and possibly driving hairs deeper.


Emergency Department Care

A patient with anaphylaxis or allergic reaction requires prompt supportive care and attention to the ABCs.

In patients with severe reaction, establish an intravenous line, provide supplemental oxygen, and place them on a cardiac monitor.


Protect areas of localized dermatitis and allergic reactions with appropriate local wound care, including wound cleansing and ice to decrease inflammation.

Determine tetanus immunization status and provide prophylaxis as needed.

Treat pruritus and erythema with antihistamines and corticosteroids.

Administer parenteral or enteral analgesics to relieve severe pain.


Ocular injury caused by tarantula hairs can be complicated and requires ophthalmologic consultation.

After initial evaluation, patients should be treated with a topical broad-spectrum antibiotic.

Topical steroids are required for patients with panuveitis or keratoconjunctivitis; they should be prescribed only after consultation with an ophthalmologist.

As with skin contact, tetanus prophylaxis is indicated when the eye is involved.



Patients can develop long-term inflammatory changes in the eye exposed to tarantula hairs, and definitive diagnosis of retained hairs cannot always be made by routine ED slit-lamp examination. Consulting an ophthalmologist is mandatory in such exposures.

Contributor Information and Disclosures

Scott D Fell, DO, FAAEM Medical Director, Emergency Department, Venice Regional Medical Center

Scott D Fell, DO, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Matthew M Rice, MD, JD, FACEP Senior Vice President, Chief Medical Officer, Northwest Emergency Physicians of TeamHealth; Assistant Clinical Professor of Medicine, University of Washington School of Medicine Pending Approval

Matthew M Rice, MD, JD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, Society for Academic Emergency Medicine, Washington State Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Robert L Norris, MD Professor, Department of Emergency Medicine, Stanford University Medical Center

Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, International Society of Toxinology, American Medical Association, California Medical Association, Wilderness Medical Society

Disclosure: Nothing to disclose.

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The Chilean rose tarantula. The urticating hairs are clearly visible. Courtesy of Mike Dembinsky.
Enlargement of tarantula hairs. Courtesy of Cara Shillington.
Slit-lamp photograph showing 2 central infiltrates caused by urticating tarantula hairs (arrows). Courtesy of Southern Medical Journal and David A. Belyea, MD.
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