Blackman J R
Rocky Mountain Center for Wilderness and Environmental Medicine, Boise, ID, USA.
J Am Board Fam Pract. 1995 Jul-Aug;8(4):288-94.
This review provides the physician with a clinical approach to the diagnosis and management of spider bites. It examines the recent literature concerning management of bites causing dermonecrosis, secondary infection, neuromuscular damage, and allergic reactions.
Using the key words "spider bites," "brown recluse spider bites," "necrotic arachnidism," "black widow spider bites," "latrodectism," and "Tegenaria agrestis (Hobo spider)," the MEDLINE files were researched for articles pertinent to the practicing physician. Texts related to spiders and spider bites were also consulted.
At least 60 species of spiders have been implicated in human bites. Most cause bites of minimal medical importance, requiring little treatment. Some (brown recluse, Hobo spider) cause severe cutaneous and systemic reactions requiring intensive medical management. The black widow bite can cause severe neurologic problems requiring the use of antivenin. Spider bites are frequently difficult to diagnose because the spider is not seen at the time of the suspected bite. Such bites should be labeled arthropod bites, vector unknown.
本综述为医生提供了一种诊断和处理蜘蛛咬伤的临床方法。它研究了近期有关导致皮肤坏死、继发感染、神经肌肉损伤及过敏反应的咬伤处理的文献。
使用关键词“蜘蛛咬伤”“褐蛛咬伤”“坏死性蛛毒中毒”“黑寡妇蜘蛛咬伤”“红斑蛛毒中毒”及“流浪蜘蛛”，检索医学文献数据库（MEDLINE）中与执业医生相关的文章。还查阅了与蜘蛛及蜘蛛咬伤相关的文献。
至少60种蜘蛛与人类咬伤有关。大多数咬伤的医学重要性极小，几乎无需治疗。有些（褐蛛、流浪蜘蛛）会引起严重的皮肤和全身反应，需要强化医疗处理。黑寡妇蜘蛛咬伤可导致严重的神经问题，需要使用抗蛇毒血清。蜘蛛咬伤常常难以诊断，因为在疑似咬伤时未见到蜘蛛。此类咬伤应标记为节肢动物咬伤，媒介不明。
