Priapism after western black widow spider (Latrodectus hesperus) envenomation

Priapism in children after a black widow spider bite is a rare phenomenon with only a few case reports noted in the literature. Black widow bites are commonly associated with pain, muscle cramping, hypertension, and tachycardia. Initial treatment includes pain control with opiate or opioid medications and benzodiazepines, with antivenom reserved for severe cases of envenomation manifested by uncontrolled pain or hypertension. Treatment with antivenom for priapism is not well described; however, it has been noted to resolve priapism in the few cases that have been reported. We present a case of a 3-year-old boy who was bitten by a black widow and presented with abdominal cramping and priapism.