A retrospective review of black widow spider envenomation.

Because there are few recent studies of black widow spider (Latrodectus Mactans) envenomation, a six-year retrospective study was conducted by patients admitted to or discharged from our hospital with this diagnosis. Fourteen patients with apparently severe envenomation were found and reviewed for the frequency of presenting signs and symptoms, the use of laboratory and radiographic studies, and the effectiveness of drug therapies. The most frequent symptoms were bite site pain (79%), abdominal pain (71%), and lower extremity weakness (57%). The most frequent signs were bite site lesions and abdominal tenderness or rigidity (71%). Laboratory and radiographic studies did not influence the initial emergency department evaluation. All drug therapies resulted in good clinical outcome despite two complications, and we therefore believe that the use of antivenom for symptomatic relief should be discouraged.