Spider bites - Assessment and management

Background: 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.

Objective: This article reviews the current literature on spider bites and describes the clinical assessment and management of the medically important spider bites.

Discussion: 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.