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CROUCHING ZOOKEEPER, HIDDEN DRAGON: A CASE OF A KOMODO DRAGON BITE

  • Nathan Friedman
    Correspondence
    Reprint Address: Nathan Friedman, MD, Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California
    Affiliations
    Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California

    Veterans Affairs San Diego Healthcare System, San Diego, California
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  • Justin Seltzer
    Affiliations
    Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California

    Veterans Affairs San Diego Healthcare System, San Diego, California
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  • Garry Winkler
    Affiliations
    Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California

    Veterans Affairs San Diego Healthcare System, San Diego, California
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  • Erin Noste
    Affiliations
    Department of Emergency Medicine, University of California, San Diego, San Diego, California
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  • Henry Montilla
    Affiliations
    Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California
    Search for articles by this author
  • Richard F. Clark
    Affiliations
    Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California
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Published:December 18, 2022DOI:https://doi.org/10.1016/j.jemermed.2022.12.001

      Abstract

      Background

      The Komodo dragon (Varanus komodoensis) is the world's largest living lizard and exists in private captivity worldwide. Bites to humans are rare and have been proposed to be both infectious and venomous.

      Case Report

      A 43-year-old zookeeper was bitten on the leg by a Komodo dragon and suffered local tissue damage with no excessive bleeding or systemic symptoms to suggest envenomation. No specific therapy was administered other than local wound irrigation. The patient was placed on prophylactic antibiotics and on follow-up, which revealed no local or systemic infections, and no other systemic complaints.

      Discussion

      Three venomous lizards have been described throughout the world. The systemic actions of their venoms have not been extensively studied, and antivenoms do not exist for their treatment. Komodo dragon bites can result in significant wound infections, but the activity of their venom is not well described.
      Why Should an Emergency Physician Be Aware of This? Although venomous lizard bites are uncommon, prompt recognition of possible envenomation and management of these bites is important. Komodo dragon bites may produce not only superficial lacerations but also deep tissue injury, but are unlikely to produce serious systemic effects; whereas Gila monster and beaded lizard bites may cause delayed angioedema, hypotension, and other systemic symptoms. Treatment in all cases is supportive.

      Keywords

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