TY - JOUR
T1 - 239. Combined Neurotoxicity and Hematotoxicity with Clinically Significant Bleeding after Mohave Rattlesnake (Crotalus scutulatus) Envenoming in Southern California
AU - Bush, Sean P.
AU - Teacher, Eric T.
AU - Daniel-Underwood, Linda
AU - Pearl, Sarah R.
AU - Westeren, Joshua
AU - Phan, Tammy H.
AU - Reibling, Ellen T.
PY - 2012/8/1
Y1 - 2012/8/1
N2 - Methods: Case report. The snake's head was examined by 4 herpetologists with unanimous agreement on speciation. Result(s): We describe a confirmed Mohave rattlesnake envenomation with angioedema, hemorrhage, neurotoxicity and rhabdomyolysis. A 31-year-old male presented 1 hour after being bitten by a Mohave rattlesnake encountered in Adelanto, California. On arrival he was tachycardic, hypotensive and altered. He had minimal tissue effects at the bite site. However, he had facial and airway angioedema. He began to complain of progressive difficulty breathing, swallowing and had extraocular muscle weakness consistent with neurotoxicity. He also developed generalized myokymia. He then had two episodes of hematemesis. The patient was intubated and airway was noted to be edematous during the procedure. Because the patient was in shock with serious active bleeding, an initial dose of 12 vials of CroFab was initiated. He continued to show signs of hemorrhaging with multiple large bloody bowel movements (approximately 1.5 L), a 8-gram drop in hemoglobin, bloody drainage from foley / gastric tubes and conjunctival hematomas. Initial labs confirmed coagulapathy, INR 3.2, Fibrinogen
AB - Methods: Case report. The snake's head was examined by 4 herpetologists with unanimous agreement on speciation. Result(s): We describe a confirmed Mohave rattlesnake envenomation with angioedema, hemorrhage, neurotoxicity and rhabdomyolysis. A 31-year-old male presented 1 hour after being bitten by a Mohave rattlesnake encountered in Adelanto, California. On arrival he was tachycardic, hypotensive and altered. He had minimal tissue effects at the bite site. However, he had facial and airway angioedema. He began to complain of progressive difficulty breathing, swallowing and had extraocular muscle weakness consistent with neurotoxicity. He also developed generalized myokymia. He then had two episodes of hematemesis. The patient was intubated and airway was noted to be edematous during the procedure. Because the patient was in shock with serious active bleeding, an initial dose of 12 vials of CroFab was initiated. He continued to show signs of hemorrhaging with multiple large bloody bowel movements (approximately 1.5 L), a 8-gram drop in hemoglobin, bloody drainage from foley / gastric tubes and conjunctival hematomas. Initial labs confirmed coagulapathy, INR 3.2, Fibrinogen
UR - https://www.sciencedirect.com/science/article/pii/S0041010112003364
UR - https://www.mendeley.com/catalogue/50694371-65c6-3720-97a2-b354f910aa26/
U2 - 10.1016/J.TOXICON.2012.04.240
DO - 10.1016/J.TOXICON.2012.04.240
M3 - Meeting abstract
VL - 60
SP - 218
JO - Toxicon
JF - Toxicon
IS - 2
ER -