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Straight, No Chaser: Spider Bites – Emergency Room Adventures, Part I

By Jeffrey Sterling, MD August 23, 2019


And I thought I was done with stuff biting you for a while… Everything’s bigger in Texas, they say. I recall the first time I saw a banana spider. The thing seemed to be as big as my fist. The only thing more surprising than that was discovering that wasps actually kill and eat spiders. I thought it was supposed to be the other way around… Anyway, I’m typing this immediately after seeing a patient who’s working around the house (or farm or barn as the case is around here), and he put his hand in the woodshed and got bit by a big spider with a red hourglass appearance. Of course, the mother’s excited and wants to know if he’s going to die. The father’s not too concerned because he was just in Missouri a month ago and was bitten by a spider that looked like it had a violin on its back (You can’t make this stuff up!).

Not a day goes by when I don’t see several patients bitten or stung by various insects, including fire ants, mosquitos, bees, wasps, ticks, scorpions and spiders. Usually everyone’s worried about a Staph infection. It’s important to note that only four American species of spiders are known to be dangerous to humans. However, there are only two types of spiders that are worth mentioning as a cause of significant disease.


Black widow spider bites are even more interesting when they’re not eating their mates after procreation (fun fact: North American black widow spiders don’t usually do that; it’s actually the Australian brand that does). They prefer to avoid humans, hanging out in outhouses, garages and the like. They become aggressive when disturbed (particularly if there’s an egg sac around), and if you’ve been bitten, it was by a female. You’ll know it was a black widow because of its red hourglass underside.

The black widow spider injects a powerful nerve toxin into humans. Once bitten, you’ll feel pain, but the real symptoms are likely to start about 20” later. Among other things, this venom produces symptoms that mimic appendicitis. Patients can develop abdominal pain and rigidity, tremor, weakness, chest pain, shortness of breath, dizziness and fainting. People at the extremes of age are more at risk for serious complications. Otherwise, reactions are rarely life threatening.


The brown recluse spider is native to the Midwest and Southeastern U.S. You’ll recognize this one by its distinctive violin pattern on its back near where its legs attach. As the name suggests, they’re not at all aggressive and tend to bite only when it’s pressed against its victim’s skin. These spiders like warm and dry environments (think attics, closets, basements, porches, barns and woodpiles).

The Brown recluse also injects a powerful venom – more so than a rattlesnake – who’s lethality is only limited because it’s such a small creature. Its venom rapidly destroys the cells it’s injected into, causing necrosis and tissue death (This is decreased as having a ‘volcano-like’ appearance at the bite site. The lead picture is a demonstration of this.). This destruction has secondary effects in humans, including kidney damage and failure, red blood cell and platelet (your clotting cells) destruction, formation of blood clots, coma and death (rarely). Deaths have only been reported in children less than age seven by the brown recluse.

Here’s your Quick Tip do’s and no’s for Spider Bites:


  • Get to the ER. Not your Doctor’s office. Not the Urgent Care.
  • Elevate the area above your heart.
  • Wash with soap and cool water.
  • Tylenol for pain.
  • Apply ice.


  • No waiting to see if it gets better.
  • No heat.
  • No suction.
  • No cutting away tissue.
  • No tourniquets.

0 thoughts on “Straight, No Chaser: Spider Bites – Emergency Room Adventures, Part I

    1. That’s correct. As I mentioned, beware of those cracks and crevices in your homes and associated structures. Thanks for being a Scoutmaster, by the way. That’s a lot of work and dedication over 20 years.

  1. Really appreciate this information. I am building a home and I currently see a lot of spiders around my apartment on the deck. That first picture is an eye opener for sure…WOW! How long did he let it go untreated in that picture?

    1. Congratulations on the home. Regarding the hand, that is the point entirely. This lesion only takes a few hours to develop. I am glad that this topic works for you. If any of you have suggestions on future blog topics, please let me know. I’m glad to be a help to you.

  2. I was in an opera in Washington DC. In one scene, we all had to sit on a rubber mat floor that had square sections (with deep groves around the squares). Who knows what was down there in the darkness).
    A day after I had been sitting on that rubber mat, I noticed that something had bitten me on the back of the leg (funny, I hadn’t felt a thing).
    It looked really bad.
    So I went to the emergency room. The lady doctor there said, “Oh my God!! That looks like the bite from a brown recluse spider.” The male doctor in the room laughed at here and said she didn’t know what she was talking about. He told her that she was wrong because there are no brown recluse spiders in the D.C. area. So he gave me some bacitricin to put on the wound and sent me home.
    Shortly after that, I got really sick with some sort of strange bronchitis and lost my voice. I ached all over. I slept in a recliner every night because I was struggling to breath. I couldn’t stop coughing (sounded like I had whooping cough). The bite area got worse and spread out a little bit more, but then, luckily, it didn’t get any wider.
    About a week later, I heard one of the opera production crew complaining about how dirty the set was. Then the other guy replied, “Well, what do you expect. This set hasn’t been used for a while. It has been sitting in a Mississippi storage facility for 7 years.
    Odds are, that lady doctor had been right all along.

    1. Exactly, Mary (and welcome!). Brown recluse spiders actually are only found in certain areas of the US (as mentioned), but several other related species cause similar, although not as deadly, effects. That said, the scenario you described sounded like it very well could have been a Brown recluse. I’m glad you’re better. Thanks for the comment and following Straight, No Chaser!

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