In North America, spider envenomation is perceived to be a greater threat than in actuality; however, it still is a valid source of morbidity and, very rarely, mortality. Only 2 groups (widows, recluses) are medically important on this continent. Widow bites affect the neuromuscular junction, have minor dermatologic expression, and are treated with analgesics and antivenom. Recluse bites vary from mild, self-limiting rashes to extensive dermonecrosis. Recent awareness of methicillin-resistant Staphylococcus aureus as a ubiquitous cause of skin injury that is often mistaken as attributable to recluse bites has questioned the credence of spiders being the cause of idiopathic wounds.
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