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Antivenin for black widow spider (Latrodectus) bites is reported to completely resolve symptoms within hours (Ann Emerg Med 1992; 21:782), but its availability is limited and it has, rarely, caused fatal anaphylaxis. A new, highly purified equine antivenin is postulated to have less potential for anaphylaxis. Investigators tested its efficacy and safety in a manufacturer-funded randomized, double-blind, placebo-controlled trial.
The multicenter trial enrolled 60 patients aged ≥10 years with suspected black widow envenomation who had pain scores ≥40 on a 100-point visual analog scale and presented within 24 hours of symptom onset. Exclusions included hypersensitivity to equine serum, almost any underlying medical or psychiatric disease, chron…