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White-tail spider bite: a prospective study of 130 definite bites by Lampona species

Geoffrey K Isbister and Michael R Gray
Med J Aust 2003; 179 (4): 199-202.

Summary

Objective: To investigate the circumstances and clinical effects of bites by white-tail spiders, including the two species Lampona cylindrata and L. murina commonly encountered by humans, and the incidence of necrotic lesions.

Design: Prospective cohort study of definite white-tail spider bites. Cases were only included if there was a clear history of bite, the spider was caught and was identified by an expert.

Setting: Calls to Australian poisons information centres and emergency departments.

Patients: 130 patients with a definite bite by a white-tail spider from February 1999 to April 2002.

Results: There were 79 bites by L. cylindrata and 51 by L. murina. Bites occurred in warmer months, 95% indoors and 75% between 16: 00 and 08: 00. The activity at the time of the bite was characteristic and the spider was encountered between bedclothes, towels or clothing. 25% of bites occurred on distal limbs. Pain/discomfort occurred in all cases, and was severe in 27%. Other effects included puncture marks (17%), redness/red mark (83%) and itchiness (44%). Systemic effects occurred in 9%. There were no cases of necrotic ulcers (97.5% CI, 0–2.8%) or confirmed infections. Median duration of effects was 24 hours (interquartile range, 1–168 hours). There were three distinct clinical patterns: pain only (21%), pain and red mark for < 24 hours (35%), and a persistent painful or irritating red lesion (44%).

Conclusions: Bites by Lampona spp. cause minor effects in most cases, or a persistent painful red lesion in almost half the cases. White-tail spider bites are very unlikely to cause necrotic ulcers, and other diagnoses must be sought.

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  • Geoffrey K Isbister1
  • Michael R Gray2

  • 1 Clinical Envenoming Research Group, University of Newcastle, Waratah, NSW.
  • 2 Division of Invertebrate Zoology, Australian Museum, Sydney, NSW.

Correspondence: 

Acknowledgements: 

We would like to acknowledge the large number of people who made this study possible, including the poison information specialists from NSW, WA and QLD poisons information centres, the nursing staff and doctors in both the Royal Darwin and Royal Prince Alfred hospital emergency departments and other clinicians who assisted in recruiting cases via the poisons information centres. Particular thanks to Bart Currie and Ian Whyte, who made it possible to organise the study and gave advice regarding the design of the study. Thanks to Tony Smith for critically commenting on the manuscript.

Competing interests:

None identified.

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