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Spider bites of medical significance in the Mediterranean area: misdiagnosis, clinical features and management

Gabriele Fusto1, Luigi Bennardo1, Ester Del Duca1,2, Daniela Mazzuca3, Federica Tamburi1, Cataldo Patruno1, Steven Paul Nisticò1 [ + show more ]

J Venom Anim Toxins incl Trop Dis, 2020, 26:e20190100
Received: 18 January 2020 | Accepted: 23 June 2020 | Published online: 02 October 2020
https://doi.org/10.1590/1678-9199-JVATITD-2019-0100

Abstract

Despite the disrepute spiders have had for centuries, their bite is a rare occurrence. In the Mediterranean area, only two of the numerous known species are considered of medical significance: Latrodectus tredecimguttatus and Loxosceles rufescens. Spider bites have no pathognomonic signs or symptoms, therefore most diagnoses are presumptive; a spider bite can only be diagnosed when a spider (seen at the time of the bite) is collected and identified by an expert, since most physicians and patients are unable to recognize a certain spider species or distinguish spiders from other arthropods. Skin lesions of uncertain etiology are too often attributed to spider bites. In most cases, these are actually skin and soft-tissue infections, allergic reactions, dermatoses etc. Misdiagnosing a wound as a spider bite can lead to delays in appropriate care, cause adverse or even fatal outcomes and have medical-legal implications. Concerningly, misinformation on spider bites also affects the medical literature and it appears there is lack of awareness on current therapeutic indications for verified bites.

 

Keywords: Spider bites; Diagnosis; Diagnostic errors; Venoms.

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