Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Aug 9;16(8):e66539.
doi: 10.7759/cureus.66539. eCollection 2024 Aug.

Bide Your Time With Bites: A Case of Rattlesnake Envenomation in Pennsylvania

Xavier Zonna  1 , Conor W Banta  2 , Ronald Lott  3 , Shweta Shah  4 , Anthony Battista  5 , Caroline Colleran  5
Affiliations
Case Reports

Bide Your Time With Bites: A Case of Rattlesnake Envenomation in Pennsylvania

Xavier Zonna et al. Cureus. .

Abstract

This case report represents a 26-year-old male with no significant past medical history who presented to the emergency department in western Pennsylvania following a western diamondback rattlesnake (Crotalus Atrox) bite to his hand. His initial swelling was mild, and his coagulation studies were unremarkable, with minimal changes on repeat studies, and poison control recommended against antivenom administration. He was discharged home with oral antibiotics and analgesics due to his stable clinical course. However, he returned to the emergency department about 12 hours later with worsening pain and swelling that extended to his elbow. He was then given antivenom and transferred to a larger center for higher-level care, ultimately having symptom resolution after further antivenom administration. This report serves to underline the importance of clinician education regarding envenomation management throughout the United States, including areas without indigenous venomous snakes.

Keywords: antivenom; coagulopathy; evenomation; rattlesnake; swelling.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Right volar hand on initial presentation
Figure 2
Figure 2. Right volar hand the following morning
Figure 3
Figure 3. Right dorsal hand 15 hours after initial presentation
Figure 4
Figure 4. Right ventral forearm 15 hours after initial presentation
See this image and copyright information in PMC

References

    1. Points & pearls: emergency department management of North American snake envenomations. Sheikh S, Leffers P, Nusbaum J, Gupta N. https://pubmed.ncbi.nlm.nih.gov/30179413/ Emerg Med Pract. 2018;20:1–2. - PubMed
    1. Snake venom poisoning in the United States. Russell FE. Annu Rev Med. 1980;31:247–259. - PubMed
    1. The epidemiology, clinical course, and management of snakebites in the North American snakebite Registry. Ruha AM, Kleinschmidt KC, Greene S, et al. J Med Toxicol. 2017;13:309–320. - PMC - PubMed
    1. CDC (NIOSH): venomous snakes. [ Apr; 2024 ]. 2020. https://www.cdc.gov/niosh/topics/snakes/default.html https://www.cdc.gov/niosh/topics/snakes/default.html
    1. Geographic and ontogenic variation in venom of the western diamondback rattlesnake (Crotalus atrox) Minton SA, Weinstein SA. Toxicon. 1986;24:71–80. - PubMed

Publication types

LinkOut - more resources