Pinprick sensation; then increasing local pain that may spread to entire extremity
Erythema appears 20-60 min after the bite; may develop characteristic halo or targetoid lesion
Pain begins to abate after several hours and disappears by 2-3d
Muscle cramp-like spasms in large muscle groups (although exam rarely reveals rigidity)
Pain becomes generalized
Severe abdominal wall musculature pain and cramping
Difficult to differentiate from peritonitis
Headache, nausea/vomiting, diaphoresis, photophobia, dyspnea
A-fib, myocarditis, priapism, and death are rare
Severe abdominal wall musculature pain and cramping
Difficult to differentiate from peritonitis
Grade 1: Range from no symptoms to local pain at the envenomation site with normal vital signs
Grade 2: Involve muscular pain at the envenomation site to migration to the trunk, diaphoresis at bite site and normal vital signs
Grade 3: Include grade 2 with abnormal vital signs; diaphoresis distant to envenomation site, generalized myalgia to<unk> , chest and abdomen, nausea vomiting and headaches.
Black widow spider bite
Hymenoptera stings 
Octopus bite
Mammalian bites
Armed spider bite
Closed fist infection 
Funnel-web spider bite
Dog bite