Black Widow Spider Envenomation

Abstract

Black widow spiders are found throughout the continental United States and north into the southern Canadian provinces. Male black widow spiders are of little medical importance. Female black widow spiders can be 20 times larger than males. The female can be identified by the hourglass pattern, red or orange in color, on the ventral aspect of her shiny, globose black abdomen. Black widow spiders control the amount of venom they inject; an estimated 15% of bites to humans are non-envenomating. Cats are very sensitive to the venom and deaths are common. Dogs have severe clinical signs but are considered more resistant than cats. A single bite is capable of delivering a lethal dose of venom to companion animals. There are several toxic components consisting of five or six biologically active proteins. These include a potent mammalian neurotoxin called alpha-latrotoxin, which induces neurotransmitter release from nerve terminals. Acetylcholine, noradrenalin, dopamine, glutamate, and enkephalin systems are all susceptible to the toxin. Onset of clinical signs usually occurs during the first 8 hours post envenomation. The condition is extremely painful in moderate to severe envenomations. Abdominal rigidity without tenderness is a hallmark sign of Latrodectus envenomation. In cats, paralytic signs may occur early and are particularly marked. Hypertension is a significant threat. First aid is of no value in the treatment. The primary treatment for black widow spider envenomation is the administration of specific antivenin, which provides the most permanent and quickest relief of the envenomation syndrome, usually within 30 minutes of infusion. The prognosis of Latrodectus envenomation is uncertain of several days, and complete recovery may take weeks.