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Spider Bite, Brown Recluse

Spider Bite, Brown Recluse is a topic covered in the 5-Minute Emergency Consult.

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Local or systemic illness caused by brown recluse spider bite envenomation


  • Brown recluse spider (also known as the fiddleback spider) features:
    • Appearance:
      • Delicate body and legs spanning 10–25 mm
      • Tan- to dark-brown with darker violin-shaped marking visible on the upper aspect of the head
      • 3 pairs of eyes
    • Found widely throughout the south-central part of US
    • Habitat: Typically warm and dry locations, indoors or outdoors such as wood piles, bundles of rags, cellars, under rocks, or in attics
    • Bites are typically defensive
  • Mechanism of toxicity:
    • Venom is a complex cocktail of enzymes and peptides that:
      • Binds to RBC and causes hemolysis
      • Causes prostaglandin release and activates complement cascade
      • Causes lipolysis and tissue necrosis
      • Triggers platelet aggregation and thrombosis
      • Triggers allergic response to venom antigenic properties
      • May lead to shock and DIC in rare cases
    • Toxicity proportional to:
      • The amount of venom relative to the size of patient
      • Location of envenomation on the body

Pediatric Considerations
  • Children are more vulnerable to a given amount of venom than healthy adults
  • Fatality more common in children due to severe intravascular hemolysis

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Rosen, Peter, et al., editors. "Spider Bite, Brown Recluse." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307157/all/Spider_Bite__Brown_Recluse.
Spider Bite, Brown Recluse. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307157/all/Spider_Bite__Brown_Recluse. Accessed April 26, 2019.
Spider Bite, Brown Recluse. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307157/all/Spider_Bite__Brown_Recluse
Spider Bite, Brown Recluse [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307157/all/Spider_Bite__Brown_Recluse.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Spider Bite, Brown Recluse ID - 307157 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307157/all/Spider_Bite__Brown_Recluse PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -