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Airway obstruction following canebrake rattlesnake envenomation

      Abstract

      We report an unusual case of canebrake rattlesnake (Crotalus horridus atricaudatus) envenomation whose major manifestation was orolingual edema and airway compromise. The likely source of swelling was mucosal absorption of venom following the first aid technique of cutting and sucking the bite site. Except for airway compromise, the patient had mild local bite site effects (swelling) and mild systemic findings (depressed fibrinogen and elevated creatinine phosphokinase). He was managed with fiberoptic nasotracheal intubation and Crotalid antivenin with good outcome.

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      References

        • Lewis J.V.
        • Portera C.A.
        Rattlesnake bite of the face.
        Am Surg. 1994; 60: 681-682
        • Dart R.C.
        • Gustafson R.A.
        Failure of electric shock treatment for rattlesnake envenomation.
        Ann Emerg Med. 1991; 20: 659-661
        • Davidson T.M.
        Intravenous rattlesnake envenomation.
        West J Med. 1988; 148: 45-47
        • Gerkin R.
        • Sergent K.C.
        • Curry S.C.
        • Vance M.
        • Nielsen D.R.
        • Kazan A.
        Life-threatening airway obstruction from rattlesnake bite to the tongue.
        Ann Emerg Med. 1987; 16: 813-816
        • Pfeiffer R.B.
        • Price V.G.
        Case report.
        Postgrad Med. 1976; 59: 283-286
      1. Martof BS, Palmer WM, Bailey JR, Harrison JR III, Dermid J. Amphibians and reptiles of the Carolinas and Virginia. Chapel Hill, NC: University of North Carolina Press; 1980;244–5.

        • Holstege C.P.
        • Miller M.B.
        • Wermuth M.
        • Furbee B.
        • Curry S.C.
        Crotalid snake envenomation.
        Crit Care Clin. 1997; 13: 889-921
        • Brick J.F.
        • Gutmann L.
        • Brick J.
        • Apelgren K.N.
        • Riggs J.E.
        Timber rattlesnake venom-induced myokymia.
        Neurol. 1987; 37: 1545-1546
        • Carroll R.R.
        • Hall E.L.
        • Kitchens C.S.
        Canebrake rattlesnake envenomation.
        Ann Emerg Med. 1997; 30: 45-48
        • Hogan D.E.
        • Dire D.J.
        Anaphylactic shock secondary to rattlesnake bite.
        Ann Emerg Med. 1990; 19: 814-816
        • Ellis E.F.
        • Smith R.T.
        Systemic anaphylaxis after rattlesnake bite.
        J Am Med Assoc. 1965; 193: 401-402
        • Glenn J.L.
        • Straight R.C.
        Distribution of proteins immunologically similar to Mojave toxin among species of Crotalus and Sistrurus.
        Toxicon. 1985; 23 ([abstract]): 28
        • Schmutz J.
        • Stahel E.
        Anaphylactoid reactions to snakebite.
        Lancet. 1985; 2: 1306
        • Nordt S.P.
        Anaphylactoid reaction to rattlesnake envenomation.
        Vet Human Toxicol. 2000; 42: 12