Survey of 2144 Cases of Red‐Back Spider Bites: Australia and New Zealand, 1963‐1976

Sutherland, Struan K.; Trinca, John C.

doi:10.5694/j.1326-5377.1978.tb131783.x

Cited by 90 publications

(66 citation statements)

References 7 publications

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“…These three studies, based on emergency department presentations, suffer from sample bias, and patients were not followed up. The largest study, of 2144 cases, 19 consisted of reports to the antivenom manufacturer, and did not define the true spectrum of definite redback spider bite.…”

Section: Discussionmentioning

confidence: 99%

Latrodectism: a prospective cohort study of bites by formally identified redback spiders

Isbister

Gray

2003

Medical Journal of Australia

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Objective: To determine the spectrum of severity and early diagnostic predictors of redback spider bites (Latrodectus hasselti ), and to examine the effect of intramuscular redback antivenom. Design and setting: Prospective cohort study of calls to New South Wales, Queensland and Western Australian poisons information centres and presentations to Royal Prince Alfred Hospital and Royal Darwin Hospital emergency departments. Patients: 68 people with definite redback spider bites in which the spider was immediately collected and expertly identified (1 February 1999 to 30 April 2002). Interventions: Intramuscular redback spider antivenom in a smaller cohort of hospitalised patients. Main outcome measures: Pain severity and duration, local effects and systemic envenomation (effects, prevalence, and persistence > 24 hours). Results: The median duration of effects was 48 hours (interquartile range, 24–96 hours). Pain occurred after all bites and was severe in 42 (62%). Forty‐five patients (66%) had pain lasting longer than 24 hours, and 22 (32%) were unable to sleep because of pain. Systemic effects occurred in 24 (35%). Increasing pain over one hour occurred in 37 cases (54%), and local/regional diaphoresis in 23 (34%); both these features were highly predictive of L. hasselti bites compared with bites of other spiders. One of six patients treated with intramuscular antivenom (17%) had no pain at 24 hours, compared with two of 17 untreated patients (12%) (difference, 5%; 95% CI, –36% to +64%; P = 0.95). There was no difference in duration of systemic effects with antivenom administration. Conclusions: Most redback spider bites cause severe and persistent effects. Intramuscular antivenom appears to be less effective than previously thought and its use by this route needs review.

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Section: Discussionmentioning

confidence: 99%

Latrodectism: a prospective cohort study of bites by formally identified redback spiders

Isbister

Gray

2003

Medical Journal of Australia

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“…The effectiveness of antivenom for red-back spider envenoming was considered excellent for many years based on case series collated by the manufacturer [37]. The limitations and biases of these early reports of effectiveness are obvious in hindsight, but were only drawn to notice when better designed prospective studies noted low treatment effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Treatments for Latrodectism—A Systematic Review on Their Clinical Effectiveness

Ryan

Buckley

Graudins

2017

Toxins

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Latrodectism or envenomation by widow-spiders is common and clinically significant worldwide. Alpha-latrotoxin is the mammalian-specific toxin in the venom that results in toxic effects observed in humans. Symptoms may be incapacitating and include severe pain that can persist for days. The management of mild to moderate latrodectism is primarily supportive while severe cases have variously been treated with intravenous calcium, muscle relaxants, widow-spider antivenom and analgesic opioids. The object of this systematic review is to examine the literature on the clinical effectiveness of past and current treatments for latrodectism. MEDLINE, EMBASE and Google Scholar were searched from 1946 to December 2016 to identify clinical studies on the treatment of latrodectism. Studies older than 40 years and not in English were not reviewed. There were only two full-publications and one abstract of placebo-controlled randomised trials on antivenom use for latrodectism. Another two randomised comparative trials compared the route of administration of antivenom for latrodectism. There were fourteen case series (including two abstracts), fourteen case reports and one letter investigating drug treatments for latrodectism with the majority of these also including antivenom for severe latrodectism. Antivenom with opioid analgesia is often the major treatment reported for latrodectism however; recent high quality evidence has cast doubt on the clinical effectiveness of this combination and suggests that other treatments need to be investigated.

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“…Acute hypersensitivity reactions occur in approximately 5% of subjects, with the incidence of anaphylaxis reported as 0.5%. Pretreatment with steroids or adrenaline is not recommended [5, 6]. A serum sickness may develop in up to 16% of subjects between 4 to 14 days after administration of antivenom [5].…”

Section: Discussionmentioning

confidence: 99%

An Irritable Infant and the Runaway Redback: An Instructive Case

Ward

Falconer

Craven

2011

Case Reports in Emergency Medicine

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The envenomation syndrome of Redback spider bites, lactrodectism, is distinctive. However diagnosis can be difficult due to an atypical presentation. We describe the case of a 1 year old boy with irritability, diaphoresis and reduced oral intake, in whom a diagnosis was made of redback spider bite. Successful resolution of symptoms was achieved following treatment with antivenom. The symptoms and management of redback spider bites is discussed.

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Survey of 2144 Cases of Red‐Back Spider Bites: Australia and New Zealand, 1963‐1976

Cited by 90 publications

References 7 publications

Latrodectism: a prospective cohort study of bites by formally identified redback spiders

Latrodectism: a prospective cohort study of bites by formally identified redback spiders

Treatments for Latrodectism—A Systematic Review on Their Clinical Effectiveness

An Irritable Infant and the Runaway Redback: An Instructive Case

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