I had an interesting patient this last week: a lady I believe was bitten by a black widow spider.
There are lots of black widows around. There were many empty lots around the house where I grew up in Sparks, Nevada. I used to go through those lots turning over rocks, boards and other junk. Almost anything I turned over would have a big black widow spider under it.
There are plenty of black widows around here, too. We don’t see people bitten by them because they are very shy and only bite when forced to.
My patient was a lady about forty-years-old who came in with pain where she was bitten on her lower back. She also had the other symptoms of black widow spider envenomation: abdominal pain, chest pain and aches in all her muscles. She was really miserable. She was trembling and her heart was racing.
There is no specific treatment for black widow spider bites. My patient was given pain medicine and intravenous fluids. Laboratory tests were done to make sure there was not something else going on. When she was feeling better and her vital signs were normal, she was sent home.
The diagnosis of black widow envenomation is made when a patient has the right signs and symptoms and the offending spider is correctly identified. In this case, when they killed the spider, they destroyed the abdomen, which is where the hourglass-shaped red spot is found. The rest of it sure looked like a black widow to me and she had the signs and symptoms. As far as I know, this is only the second one I have seen in my thirty years of practicing emergency medicine.
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