28362 Black widow spider bite: A common creature in an uncommon geographic location

Abstract

The black widow spider is one of the most clinically significant spiders worldwide. Although considered ubiquitous, they are not endemic to the Caribbean. We present the case of a 52-year-old male patient with acute onset of painful erythematous soft tissue inflammation with associated diaphoresis, chills, and ipsilateral periorbital edema after identifying a black widow spider near his bed. Physical examination revealed multiple tense bullae in a violaceous background involving his thenar eminence and left thumb with associated visible fang marks. Notable vital sign and laboratory abnormalities included elevated blood pressure (156/92 mmHg), neutrophilia (16,900 cells/μL), elevated CPK (18,510 U/L), and transaminitis (ALT 91 U/L, AST 236 U/L). The patient was managed with local wound care and supportive treatment. To our knowledge, one similar case has been described in Puerto Rico. Given the scarcity of similar reports in the Caribbean and Latin America, our case highlights the importance of thorough history taking and prompt recognition of early clinical and laboratory features that should alert physicians to consider black widow spider envenomation in the appropriate clinical scenario.