title: Recognition and successful treatment of priapism and suspected black widow spider bite with antivenin.
abstract: Priapism, although uncommon in preadolescent children, is considered a true emergency. Envenomation by a black widow spider bite has been reported to induce priapism as a manifestation of its toxicity. Early recognition and timely administration of antivenin have been reported to be effective in relieving priapism. Clinicians who care for children need to be aware of this unusual presentation. The diagnosis is traditionally from either direct observation of a spider bite or capture of a spider. We report a case of a previously healthy 2-year-old boy who presented with severe irritability, leg cramps, and stomach ache. The diagnosis of a likely black widow spider envenomation was made on the basis of clinical suspicion and suggestive physical findings in absence of demonstrated exposure. This case highlights the importance of early recognition and successful resolution of symptoms with administration of antivenin and supportive care.
authors.affiliation: From the *Department of Pediatric Emergency Medicine, Children's Healthcare of Atlanta and †Emory University School of Medicine, Atlanta, GA.
authors.forename: Sheila Choudhury
authors.initials: SC
authors.lastname: Goel
authors.forename: Mouhammad
authors.initials: M
authors.lastname: Yabrodi
authors.forename: James
authors.initials: J
authors.lastname: Fortenberry
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D001740:Black Widow Spider; D002675:Child, Preschool; D006801:Humans; D008297:Male; D011317:Priapism / Q000188:drug therapy* / Q000209:etiology*; D012074:Remission Induction; D001098:Spider Bites / Q000150:complications*; D013111:Spider Venoms / Q000037:antagonists & inhibitors*
chemical_list: D000997:Antivenins; D013111:Spider Venoms