Canebrake Rattlesnake Envenomation

Study objective: To document the clinical presentation and course of consecutive cases of envenomation by the canebrake rattlesnake ( Crotalus horridus atricaudatus). Methods: The medical care provided all patients envenomated by canebrake rattlesnakes in two institutions was retrospectively reviewe...

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Bibliographic Details
Published in:Annals of emergency medicine 1997-07, Vol.30 (1), p.45-48
Main Authors: Carroll, Robert R, Hall, Edward L, Kitchens, Craig S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Animal poisons toxicology. Antivenoms
Animals
Antivenins - administration & dosage
Biological and medical sciences
Child
Child, Preschool
Crotalid Venoms - adverse effects
Crotalid Venoms - antagonists & inhibitors
Crotalus
Emergencies
Fatal Outcome
Humans
Male
Medical sciences
Middle Aged
Retrospective Studies
Rhabdomyolysis - etiology
Snake Bites - complications
Snake Bites - therapy
Toxicology
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Summary:Study objective: To document the clinical presentation and course of consecutive cases of envenomation by the canebrake rattlesnake ( Crotalus horridus atricaudatus). Methods: The medical care provided all patients envenomated by canebrake rattlesnakes in two institutions was retrospectively reviewed. Particular attention was paid to coagulation abnormalities, serum enzymes, electrocardiographic findings, and treatment with antivenom. Results: Of the 15 patients, envenomation was judged to be mild in 3, moderate in 6, and severe in 5. In one case envenomation caused death. The clinical course generally predicted the degree of increase in the serum creatinine kinase (CK) level, as well as the amount of antivenom used for treatment. Despite increases in serum CK concentration and frequent increases in the serum CK-MB fraction, we found no evidence of cardiac damage. Conclusion: In envenomation by North American pit vipers, rhabdomyolysis appears to be characteristic of envenomation by the canebrake rattlesnake. We speculate that toxins in the canebrake venom cause skeletal muscle rhabdomyolysis. Physicians caring for victims of canebrake bite should regard marked increases in CK concentration as coming from skeletal, not cardiac, muscle. Good general medical support and antivenom for victims with moderate to severe envenomation appears effective. [Carroll RR, Hall EL, Kitchens CS: Canebrake rattlesnake envenomation. Ann Emerg Med July 1997;30:45-48.]
ISSN:0196-0644
1097-6760
DOI:10.1016/S0196-0644(97)70109-4