Green lynx spider (Peucetia viridans) envenomation

Green Lynx Spider (Peucetia viridans) Envenomation SEAN P. BUSH, MD,* PAUL GIEM, MD,* AND RICHARD S. VETTER, MSt Fourcasesof envenomationby greenlynxspiders(Peucetia viridans)are reported. Despite the unusual appearance and occasional aggressive behavior of this spider, envenomationcaused only local pain, pruritis, erythema, and induration. No local necrosis or systemic symptoms occurred. Treatment included tetanus immunization,wound care, and symptomatictherapy.(Am J Emerg ied 2000;18:64-66.Copyright© 2000 by W.B. SaundersCompany) Green lynx spiders (Peucetia viridans) are notable for their unusual appearance, aggressive nesting behavior, and venom "spitting." 1-4 Only 2 reports on the clinical effects of green lynx spider envenomation were found on a review of the literature. 1,4 In the largest reported case series, we describe 4 cases of envenomation by P. viridans. while reaching into bushes. He was concerned that it could be a black widow spider (Latrodectus hesperus), and he immediately "lanced [the wound] and sucked the venom out" by mouth at the time of the bite. He located the spider in the bushes and described it as large (approximately 2.5 cm) and green with brown stripes on the legs. He described localized pain which persisted until the following morning and resolved spontaneously. No systemic symptoms were reported. On examination, there was a small nontender puncture wound on the dorsal mid-forearm with minimal surrounding erythema and no necrosis. Vital signs were normal. The physical examination was otherwise unremarkable. The patient's tetanus immunization was up to date. He was discharged with wound care instructions. The patient denied symptoms of infection or necrosis on a follow-up phone call. CASE1 CASE 3 A 12-year-old healthy girl was bitten by a spider on the left forearm while painting the outside of her house 30 minutes before arrival to the emergency department (Table 1). She brought the live spider to the emergency department, where it was identified as a green lynx spider by the authors and photographed (Figure 1). She complained of a sharp pain initially at the site of the bite followed by mild local burning and pruritis. She denied systemic symptoms. Vital signs were normal. At the bite site, there were 2 separate fang marks approximately four millimeters apart surrounded by a two millimeter ring of erythema and induration (Figure 2). The examination was otherwise normal. The wound was cleansed and a sterile bandage was applied. The patient was given a tetanus vaccination and was discharged with wound care instructions. On follow-up examination 2 days later, symptoms had resolved, and no necrosis of the wound was noted. A 65-year-old man presented to the emergency department 3 hours after being bitten on the right forearm by a spider. He brought it to the emergency department, where it was identified as a green lynx spider by the second author. The patient complained of pain and pruritis to the area and a 1-cm urticarial lesion, all of which resolved spontaneously about an hour after the bite. He reported no systemic symptoms. On examination, there was a small puncture wound with less than 1 mm of surrounding erythema and induration. Vital signs were normal. The patient was not given a tetanus vaccination. The patient reported no wound necrosis, infection, or any other complications on follow-up. CASE 2 A 22-year-old healthy man presented to the emergency department 24 hours after being bitten on the left forearm by a spider From the *Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, and the tDepartment of Entomology, University of California Riverside, Riverside, CA. Manuscript received May 6, 1998, returned July 8, 1998; revision received February 1, 1999, accepted March 21,1999. Address reprint requests to Dr S Bush, Department of Emergency Medicine, Loma Linda University Medical Center, Room A108, 11234 Anderson St, Loma Linda, CA, 92354. E-mail: famensean@aol.com Key Words: Spider, envenomation, venom, poison, animal bites, arachnid. Copyright © 2000 by W.B. Saunders Company 0735-6757/00/1801-0015510.00/0 64 CASE 4 A man in his mid-fifties presented information regarding a green lynx spider bite to the third author. As he was gardening among rose bushes, a green lynx spider landed on his dorsal right forearm and bit him. The bite site was erythematons and mildly painful for about 1 day before resolving. He reported no systemic symptoms and no subsequent necrosis. He did not seek medical treatment. DISCUSSION Green lynx spiders are large, strikingly colored (Figure 1), and occasionally aggressive. Their bright green coloration, size, and spindly legs covered with conspicuous spiny hairs jutting out perpendicularly make them unique in appearance, unlike any other spider in their range. Their range extends from coast to coast in the southern US to Central America. 2,5 They are commonly found in grasses (such as buckwheat), cultivated home gardens (among plants such as rose bushes), BUSH ET AL • GREEN LYNX SPIDER ENVENOMATION and in agroecosystems (on plants such as cotton or soybeans). The spider's "bizarre" appearance has been reported to contribute to concerns that the species may be exotic, motivating patients to seek medical attention. ~ Its appearance alone may prompt patients to capture the spider and submit it for identification. ~ Russell reports P. viridans was one of 14 species of spiders brought into the hospital for identification out of 73 cases of spider bites in southern California. 6 P. viridans is listed among "reported or potentially dangerous" spiders in the US. 7 Females have been reported to "vigorously" guard egg sacs and newly emerged young. 2,s,s One author reports a female green lynx spider, while guarding an egg sac, bit the end of a pencil that was poked at the egg case leaving an impression of her fang marks in the graphite. 2 Of note, all envenomations in our series, as well as those previously reported (when date was known), occurred in September and October, which corresponds to the approximate time of year when adult females constitute the majority of the population and egg sacs are constructed. ~,3 All bites in our series occurred in the late afternoon and evening. Envenomated patients ranged from age 12 to 65 years. All bites in our series and in previous reports occurred in southern California and occurred on the distal upper extremity. Venom "squirting" or "spitting" has been described, in which green lynx spiders were reported to forcibly expel venom to strike targets almost 40 centimeters FIGURE 1. Green lynx spider (Peucetia viridans). Photo by Sean R Bush, MD. 65 FIGURE 2. Site of envenomation by green lynx spider. (The ring around the bite site is adhesive from a bandage.) Photo by Sean E Bush, MD. away. 3,4 Venom is suspected to be proteolytic according to one source, ~ but has not been evaluated by chemical analysis.3 In the only other published case series Hall and Madon ~ describe 2 patients. One patient developed localized burning, itching, hyperesthesia, and 25 mm of swelling and erythema which lasted at least 2 days and resolved spontaneously without specific treatment. The other patient had burning, itching, hyperesthesia, a pustular lesion, central induration, and a large (10 to 20-cm diameter) area of swelling. This patient also had a headache. He was treated with diphenhydramine and tetanus vaccination. A 3-mm ulcer was noted on reevaluation 24 hours later, which the authors suggest may have been the result of the patient scratching the wound. A case report from 1946 describes one patient who was struck in the eye by a venom-spitting green lynx spider. 4 This ocular envenomation resulted in immediate pain, visual impairment, and a moderate to severe conjunctivitis which resolved after 3 days. 3,4 Venom-spitting is thought to be purely defensive and has not been observed in predatory behavior. 3 The literature cited above was also found cross-referenced in a few other sources, but we found no other mention of P. viridans on a review of the medical literature. 9,1° Based on our experience and that described in the literature, the clinical course following the bite of the green lynx spider appears benign, self-limited, and unlikely to be associated with serious sequelae. It is unclear how envenomation might affect children or the elderly. Envenomation does not appear to be associated with wound necrosis or severe systemic symptoms. We recommend treating green lynx spider bites with routine wound care, tetanus prophylaxis, and symptomatic treatment. 66 AMERICAN JOURNAL OF EMERGENCY MEDICINE • Volume 18, Number 1 • January 2000 TABLE1. Characteristics of Patients Envenomated by Green Lynx Spiders Site of Exposure Case Bush, Giem, and Vetter 1 12/F Sept. 18, 1997, Forearm 4:30 pm 2 22/M Sept. 6, 1994, 10:00 pm Forearm 3 65/M Sept. 1, 1994, 7:00 pm Forearm 4 Mid-fifties/M Not recorded Forearm 1 Middleaged/F Oct. 8, 1968 Forearm 2 Young adult/M Sept. 7, 1971 Hand 1 Young adult/M Sept. 21, 1943 Eye Hall and Madon 1 Tinkham4 Age/Sex Date/Time of Bite Reference Location of Bite Colton, California Clinical Manifestations Local pain, burning, pruritis, mild erythema (<0.5 cm), induration resolving in <2 days San Bernardino, Local pain, puncture wound, erythema California resolving in <12 hours Calimesa, Localpain, pruritis, California urticarial lesion (1 cm) resolving in one hour Riverside, Pain and erythema California resolving in 1 day SantaAna, Local burning, pruCalifornia ritis, hyperesthesia, erythema, and swelling (2.5 cm) lasting at least 2 days Anaheim, Local burning, pruCalifornia ritis, hyperesthesia, pustular lesion with central induration, swelling (10-20 cm), headache. All but a 3-mm ulcer resolved by 24 hours Boca Raton, Local burning pain, Florida visual impairment, moderate to severe conjunctivitis resolving in 3 days The authors wish to thank Steve Green, MD, for his review of this manuscript and many helpful suggestions. REFERENCES 1. Hall RE, Madon MB: Envenomation by the green lynx spider Peucetia viridans (Hentz 1832), in Orange County, California. Toxicon 1973;11:197-199 2. Brady AR: The lynx spiders of North America, north of Mexico (Araneae: Oxyopidae). Bull Mus Comp Zool, Harvard Univ 1964;131: 429-518 3. Fink LS: Venom-spitting by the green lynx spider, Peucetia viridans (Araneae, Oxyopidae). J Arachnology 1984;12:372-373 4. Tinkham ER: A poison-squirting spider. Bull U S Army Med Dept 1946;5:361-362 Treatment Wound cleansed and bandaged, tetanus vaccine, wound care instruction Circumstances Painting house exterior Wound care instruc- Trimming bushes tion None Not documented None Gardening None Pruning flowers (spider nesting) Unpacking shipping Tetanus vaccination, diphenhydra- carton (from Mexicali) mine Not reported Inspecting motorcycle tail light; prodded spider with screwdriver 5. Gertsch W J: American Spiders, ed 2. New York, Van Nostrand Reinhotd Co, 1979;233:197-199 6. Russell FE, Waldron WG: Spider bites, tick bites. Calif Medicine 1967;106:248 7. Horen WP: Arachnidism in the United States. JAMA 1963;185: 839-843. 8. Whitcomb WH: Egg-sac construction and oviposition of the green lynx spider, Peucetia viridans (Oxyopidae). Southwestern Naturalist 1962;7:198-201 9. Hassen LVB, McNally JT: Spider bites, In Auerbach PS (ed): Wilderness Medicine, ed 3. St. Louis, Mosby, 1995:769-786 10. Wong RC, Hughes SE, Voorhees J J: Spider Bites. Arch Dermatol 1987;123:98-104