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Funnel-web spider envenomation — RACP Paediatrics MCQ

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HardEmergencyFunnel-web spider envenomationRACP Paediatrics

A 2-year-old is brought to the ED in rural NSW after being bitten on the hand by a large black spider seen in the garden. The child develops profuse sweating, salivation, muscle fasciculations, and hypertension. What is the most likely envenomation and specific treatment?

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Correct answer: A — Spider bite (funnel-web)

A large black spider in eastern Australia causing severe pain with autonomic features (sweating, salivation, fasciculations, hypertension) is funnel-web spider envenomation. This is a medical emergency. Pressure immobilisation bandaging should be applied. Funnel-web spider antivenom should be administered as soon as possible. Multiple vials may be needed. Children are particularly susceptible.

Reference: RCH Melbourne – 2023 – Spider Bite CPG; Australian Therapeutic Guidelines – 2024 – Toxicology