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Should Your Child See a Doctor?

Spider Bite

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Definition

  • Bite from a spider

Symptoms 

  • Bite symptoms include redness, pain, swelling
  • Helpful if spider seen on the skin or in close proximity to the child

First Aid Advice for Black Widow Spider Bites: Apply an ice cube or ice pack to the bite for 20 minutes to reduce the spread of the venom (no tourniquet).

First Aid Advice for Shock: Lie down with the feet elevated.

Types of Spider Bites

Black Widow Spider Bite 

  • A shiny, jet-black spider with long legs (total size 1 inch).
  • A red (or orange) hourglass-shaped marking on its under-side.
  • Causes immediate local mild pain, swelling and occasionally 2 fang marks.
  • Severe muscle cramps (especially abdominal wall cramps) are present by 1 to 6 hours, and last 24 to 48 hours.
  • Rarely causes death (EXCEPTION: bitten by several spiders or small child is bitten)
  • Note: Many are dry bites because the fangs are small.
  • The brown widow spider is related to the black widow and is found in the southern U.S.
  • Brown widow spider bites are treated the same as a black widow bite.

Brown Recluse Spider Bite 

  • A brown spider with long legs (total size 1/2 inch).
  • A dark violin shaped marking on top of its head
  • Causes local pain and delayed blister formation in 4 to 8 hours
  • The center becomes bluish and depressed (crater-like) over 2 to 3 days
  • Skin damage may require skin grafting in 10% of cases.
  • Systemic symptoms such as fever, vomiting, muscle pain can occur (but no life-threatening symptoms).
  • Since brown recluse spiders are hard to identify, bring the spider along in a jar.

Non-dangerous Spider Bites 

  • More than 50 spiders in the U.S. have venom and can cause local, nonserious reactions.
  • The bites are painful and mildly swollen for 1 or 2 days (much like a bee sting).
  • Many single, unexplained, tender bites that occur during the night are due to spiders.

When to Call Your Doctor for Spider Bite

Call 911 If…

 
  • Your child has passed out or is too weak to stand
  • Your child has difficulty breathing or is wheezing

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Widow spider (black, brown, red, etc.) bite suspected
  • Abdominal pain, chest tightness or other muscle cramps
  • Bite pain is severe
  • Bite looks infected (red streaking from the bite area, yellow drainage). (Note: infection doesn't start until at least 24-48 hours after the bite. Any redness in the first 24 hours is due to venom)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Bite starts to look bad (e.g., skin damage, blister or purplish - not just swelling)
  • Bite pain persists over 2 days

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Non-serious spider bite and you don't think your child needs to be seen

Home Care Advice for Non-Dangerous Spider Bites

  1. Cleansing: Wash the bite thoroughly with soap and water.
  2. Meat Tenderizer: Rub the bite area with a cotton ball soaked in a meat tenderizer solution for 20 minutes (EXCEPTION: avoid if near the eye). Do this once. If not available, apply an ice cube in a wet washcloth for 20 minutes.
  3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for pain.
  4. Expected Course: Some swelling and pain for 1 to 2 days. It shouldn't be any worse than a bee sting.
  5. Call Your Doctor If:
    • Severe bite pain persists over 2 hours after pain medicine
    • Abdominal pains or muscle spasms occur
    • Local pain lasts over 2 days (48 hours)
    • Bite begins to look infected
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. Bond GR. Snake, spider and scorpion envenomation in North America. Pediatr Rev. 1999;20:147-152.
  2. Clark RF, et al. Clinical presentation and treatment of black widow spider envenomation: A review of 163 cases. Ann Emerg Med. 1992;21:782.
  3. Herman BE and Skokan EG. Bites that poison: A tale of spiders, snakes and scorpions. Contemp Pediatr. 1999;16(8):41-62.
  4. Koh WL. When to worry about spider bites: Inaccurate diagnosis can have serious, even fatal consequences. Postgrad Med. 1998;103:235-6, 243-4, 249-50.
  5. Mofenson HC and Caraccio TR. Spider bites aren't an itsy-bitsy problem in kids. Contemp Pediatr. 1993 Jul;10:18-35.
  6. Swanson DL, et.al. Bites of brown recluse spiders and suspected necrotic arachnidism. N Eng J Med. 2005;352:700.
  7. Wright SW, Wrenn KD, Murray L, Seger D. Clinical presentation and outcome of brown recluse spider bite. Ann Emerg Med. 1997;30:28-32.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/30/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.

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