Isbister Geoffrey K, Gray Michael R
University of Newcastle, Newcastle, Australia.
J Toxicol Clin Toxicol. 2003;41(6):809-19. doi: 10.1081/clt-120025346.
The family Theridiidae (comb-footed spiders) contains the well-known and medically important widow spider group (Latrodectus spp.). Little is known about the effects of envenoming by other common members of this family.
The objective of this study was to determine the clinical effects of bites by common theridiid spiders of the genera Steatoda and Achaearanea.
This was a prospective cohort study of calls to Australian poison information centers and presentations to emergency departments. Twenty-eight persons with a definite bite by a spider of the family Theridiidae, excluding Latrodectus spp., were included where the spider was immediately collected and expertly identified from February 1999 to April 2002.
There were 23 bites by Steatoda spp. and five bites by Achaearanea spp. Steatoda bites occurred across Australia, throughout the year, and the majority during waking hours. Seventy-eight percent of bites occurred indoors and 48% while dressing indoors. Pain was universal and was severe in six (26%). Increasing pain in the first hour occurred in 30%, and the median duration of pain was 6 hr (interquartile range: 1-12 hr). Local or regional diaphoresis did not occur. Systemic effects occurred in 30% and included nausea, headache, lethargy, and malaise. The majority received no treatment: seven patients presented to a hospital (two patients received opiates for analgesia) and 1 patient inadvertently received intravenous redback spider (RBS) antivenom because the spider was initially misidentified as a RBS (Latrodectus). The pain and symptoms responded over 1 hr following antivenom administration. Bites by Achaeranea spp. caused moderate to severe persistent pain, but no systemic effects.
Steatoda spp. bites or "steatodism" may cause prolonged pain and systemic effects similar to Latrodectus bites, but less severe. In severe cases, the clinical effects were almost indistinguishable from Latrodectus, except diaphoresis was absent, and the spiders were often mistaken for Latrodectus. Intravenous RBS antivenom appears to be an effective treatment in isolated severe cases, consistent with in vitro work. Achaearanea bites caused pain similar to Latrodectus bites.
球蛛科（栉足蛛）包含广为人知且具有医学重要性的寡妇蛛属（间斑寇蛛属）。对于该科其他常见成员的毒液影响了解甚少。
本研究的目的是确定Steatoda属和Achaearanea属常见球蛛叮咬的临床影响。
这是一项对澳大利亚毒物信息中心来电及急诊就诊情况的前瞻性队列研究。纳入了28名被球蛛科蜘蛛（不包括间斑寇蛛属）明确叮咬的患者，这些蜘蛛于1999年2月至2002年4月被立即收集并由专家鉴定。
有23例为Steatoda属蜘蛛叮咬，5例为Achaearanea属蜘蛛叮咬。Steatoda属蜘蛛叮咬在澳大利亚全年均有发生，大多数发生在清醒时间。78%的叮咬发生在室内，48%发生在室内穿衣时。疼痛普遍存在，6例（26%）疼痛严重。30%的患者在最初1小时内疼痛加剧，疼痛的中位持续时间为6小时（四分位间距：1 - 12小时）。未出现局部或区域性出汗。30%的患者出现全身症状，包括恶心、头痛、嗜睡和不适。大多数患者未接受治疗：7名患者前往医院就诊（2名患者接受了阿片类药物镇痛），1名患者因蜘蛛最初被误认成红背蛛（间斑寇蛛）而无意中接受了静脉注射红背蛛抗蛇毒血清。注射抗蛇毒血清后1小时内疼痛和症状有所缓解。Achaearanea属蜘蛛叮咬导致中度至重度持续性疼痛，但无全身症状。
Steatoda属蜘蛛叮咬或“Steatodism”可能会引起与间斑寇蛛叮咬相似的持续性疼痛和全身症状，但程度较轻。在严重病例中，临床症状几乎与间斑寇蛛叮咬无法区分，只是不出汗，而且这些蜘蛛常被误认为是间斑寇蛛。静脉注射红背蛛抗蛇毒血清在个别严重病例中似乎是一种有效的治疗方法，这与体外研究结果一致。Achaearanea属蜘蛛叮咬引起的疼痛与间斑寇蛛叮咬相似。
