title: Clinical and in vitro evidence for the efficacy of Australian red-back spider (Latrodectus hasselti) antivenom in the treatment of envenomation by a Cupboard spider (Steatoda grossa).
abstract: We report the case of a 22-year-old female who was bitten on the shoulder by a spider subsequently identified as a female Cupboard spider (Steatoda grossa). She developed nausea, vomiting, and severe local and regional pain, similar to that seen in latrodectism. Symptoms were treated successfully with red-back spider antivenom (RBSAV). We also present in vitro data, which supports this clinical observation, and suggests that S. grossa venom is immunogenically reactive with both RBSAV and latrotoxin (LTx)-specific antibodies by Western blotting. Moreover, the effects of S. grossa venom on the isolated chick biventer cervicis nerve-muscle preparation are dose-dependent and similar to those seen with Latrodectus spp. venoms. S. grossa venom produced a sustained muscle contracture which could be prevented by pre-incubation of venom with RBSAV. Venom effects could also be reversed by the addition of antivenom after application of venom to the preparation. Although severe envenomation is uncommon following the bite of Steatoda spp. it may resemble latrodectism. These results indicate that RBSAV is likely to be effective in reversing symptoms of envenomation and should be considered in the treatment of patients with distressing or persisting symptoms.
authors.affiliation: Department of Emergency Medicine, Westmead Hospital, Hawkesbury Road, Westmead, Sydney, NSW 2145 Australia. andis.graudins@uts.edu.au
authors.forename: Andis
authors.initials: A
authors.lastname: Graudins
authors.forename: Narendra
authors.initials: N
authors.lastname: Gunja
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Broady
authors.forename: Graham M
authors.initials: GM
authors.lastname: Nicholson
mesh_terms: D000328:Adult; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D001740:Black Widow Spider / Q000145:classification / Q000276:immunology; D015153:Blotting, Western; D002645:Chickens; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D009119:Muscle Contraction / Q000187:drug effects; D009469:Neuromuscular Junction / Q000187:drug effects; D009500:Neutralization Tests; D001098:Spider Bites / Q000188:drug therapy* / Q000276:immunology; D013111:Spider Venoms / Q000276:immunology / Q000494:pharmacology / Q000506:poisoning*; D016896:Treatment Outcome
chemical_list: D000997:Antivenins; D013111:Spider Venoms