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ACMT Toxicology Visual Pearls: Spider Bite


A patient presents to the ED for management of a spider bite. Which of the following statements is correct regarding a bite from the spider pictured?

  1. Laboratory studies can be helpful in management and predicting outcome.
  2. Antibiotics are recommended.
  3. The venom is cytotoxic and can cause red blood cell hemolysis.
  4. The venom is more potent on a volume-per-volume basis than the venom of a pit viper.

Reveal the Answer

This post was expert peer-reviewed by Drs. Bryan Judge, Louise Kao, and Andrew Monte.

The American College of Medical Toxicology (ACMT) hosts this Toxicology Visual Pearls series
Hahn I. Arthropods. In: Goldfrank’s Toxicologic Emergencies. 10th ed. New York, NY: McGraw-Hill; 2015:1000-1002.
Monte A, Bucher-Bartelson B, Heard K. A US perspective of symptomatic Latrodectus spp. envenomation and treatment: a National Poison Data System review. Ann Pharmacother. 2011;45(12):1491-1498. [PubMed]
Clark R, Wethern-Kestner S, Vance M, Gerkin R. Clinical presentation and treatment of black widow spider envenomation: a review of 163 cases. Ann Emerg Med. 1992;21(7):782-787. [PubMed]
Nordt S, Clark R, Lee A, Berk K, Lee C. Examination of adverse events following black widow antivenom use in California. Clin Toxicol (Phila). 2012;50(1):70-73. [PubMed]
Monte A. Black widow spider (Latrodectus mactans) antivenom in clinical practice. Curr Pharm Biotechnol. 2012;13(10):1935-1939. [PubMed]
Dart R, Bogdan G, Heard K, et al. A randomized, double-blind, placebo-controlled trial of a highly purified equine F(ab)2 antibody black widow spider antivenom. Ann Emerg Med. 2013;61(4):458-467. [PubMed]
Adrienne Hughes, MD

Adrienne Hughes, MD

Adjunct Instructor
Toxicology Fellow, Department of Emergency Medicine
Oregon Health & Science University
Adrienne Hughes, MD

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Robert G. Hendrickson, MD

Robert G. Hendrickson, MD

Professor, Department of Emergency Medicine
Oregon Health & Science University
Director, Emergency Medicine Toxicology Fellowship, Oregon Poison Center
Associate Medical Director, Oregon Poison Center
Robert G. Hendrickson, MD

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