Black Widow
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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Comments (3)
Elizabeth
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Wow! Is this bite life threatening? Any idea how she encountered it?
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Tad
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Very rarely life-threatening. My guess about how it happened is that, somehow, the spider got caught under her clothing.
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Travis
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I used to see a lot of black widows when I was a kid growing up in Utah, and I still see them occasionally, but not nearly as often as I used to. I have had two memorable experiences with them, though. Once when I was backpacking in Canyonlands I set up camp under the shelter of a rock face, and when I woke up in the morning I saw the entire cliff I had slept under was covered with black widows. Very creepy. And much creepier still, back when I was working my way through college and doing a lot of construction and remodeling work, a woman asked my to build her some shelves in a root cellar. I had to fumble around a bit to find the string-pull light, and when I turned it on I was literally surrounded by webs of black widows and other spiders. How I had managed to walk through them without getting spiders all over my face and body was a mystery to me. It was an Indiana Jones moment I’d prefer never to repeat.
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