The spider injects phospholipase D (sphingomyelinase D) when it bites.
Clinical features of the typical exposure:
(1) The patient may experience a sudden, sharp sensation that may be recognized as a bite.
(2) A painful papule develops at the site and is surrounded by erythema.
(3) The patient may develop systemic symptoms with fever and myalgias.
Most bites occur on an extremity but they can occur anywhere on the body, especially if the person is bitten while in bed.
Complications can be severe and may incude:
(1) In more severe cases the lesion becomes black and necrotic, then ulcerates. The lesions can be quite large and can take months to heal.
(2) secondary bacterial infection, including osteomyelitis
(3) hemolytic anemia
(4) rhabdomyolysis
(5) renal failure
(6) methemoglobinemia
(7) anaphylaxis
(8) scarring
Delayed healing of an ulcer is associated with:
(1) older age
(2) diabetes
(3) treatment delay
(4) more severe lesions
