Spider bites of medical significance in the Mediterranean area: misdiagnosis, clinical features and management

 

Gabriele Fusto1 , Luigi Bennardo1, Ester Del Duca1,2 Daniela Mazzuca3 , Federica Tamburi1 , Cataldo Patruno1 , Steven Paul Nisticò1

 

1 Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.

2 Department of Dermatology, Mount Sinai Medical Center, New York, USA.

3 Unit of Forensic Pathology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy

 

Abstract

Despite the disrepute spiders have had for centuries, their bite is a rare occurrence. In the Mediterranean area, only two of the numerous known species are considered of medical significance: Latrodectus tredecimguttatus and Loxosceles rufescens. Spider bites have no pathognomonic signs or symptoms, therefore most diagnoses are presumptive; a spider bite can only be diagnosed when a spider (seen at the time of the bite) is collected and identified by an expert, since most physicians and patients are unable to recognize a certain spider species or distinguish spiders from other arthropods. Skin lesions of uncertain etiology are too often attributed to spider bites. In most cases, these are actually skin and soft-tissue infections, allergic reactions, dermatoses etc. Misdiagnosing a wound as a spider bite can lead to delays in appropriate care, cause adverse or even fatal outcomes and have medical-legal implications. Concerningly, misinformation on spider bites also affects the medical literature and it appears there is lack of awareness on current therapeutic indications for verified bites.

 

Keywords: Spider bites Diagnosis Diagnostic errors Venoms

 

Correspondence: luigibennardo10@gmail.com

 

Received: 18 January 2020; Accepted: 23 June 2020; Published online: 02 October 2020