Abstract
Introduction
Black widow spider (BWS) envenomation is a risk in much of the United States. The America’s Poison Centers National Poison Data System (NPDS) contains the most comprehensive dataset of poisonings and envenomations in the United States.
Objective
We sought to research the BWS human exposure trends and descriptively assess the relevant demographic and clinical characteristics of such exposures using the NPDS.
Methods
The NPDS was queried for all closed human exposures to BWSs from January 1, 2012, through December 31, 2022, using the generic code identifier 0194000. Data extracted included age, clinical effect, exposure site, gender, level of healthcare facility care, medical outcome, reason, start date month, and therapy. We identified and descriptively assessed the relevant demographic and clinical characteristics.
Results
During the study period, there were 15,366 BWS exposures reported. Clinical effects revealed 9159 (59.6%) with a puncture wound, 7017 (45.7%) reported pain at the dermal site, and 2835 (18.5%) reported pain other than dermal. Pediatric cases comprised 3226 (21.0%). There were 6828 females, of which 67 were pregnant. Medical outcomes documented that 3118 (20.2%) had moderate effects and 121 (0.8%) major effects. There were no deaths. A total of 6508 were seen in the emergency department (42.4%); 1221 (8.0%) were admitted to a noncritical care unit, and 327 (2.1%) were admitted to a critical care unit. Therapies given most commonly were opioids, benzodiazepines, antihistamines, and antiemetics. Only 16 required intubation with mechanical ventilation. Antihypertensive drugs were administered rarely (89). Antivenom was administered in 521 (3.4%). Exposures occurred during every month of the year, with August and September having the highest numbers.
Conclusions
Black widow spider exposures are commonly reported to America’s Poison Centers. Despite the potential for marked adverse clinical effects, a significant number of patients who had a documented puncture wound were able to be managed without hospitalization and with conservative management.
Keywords: spider, black widow, envenomation