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Southern Pacific Rattlesnake bite: a unique clinical challenge.
J Emerg Med. 2006 Oct; 31(3):263-6.JE

Abstract

The Southern Pacific Coast Rattlesnake (Crotalus Helleri) is responsible for most of the snake bites in the coastal area of California from Los Angeles to San Diego. However, Crotalidae polyvalent immune ovine Fab fragments are not made from the venom of C. Helleri. This sheep-derived antivenom is indicated only in moderate snakebite envenomations. Very scant data are available regarding venom-induced thrombocytopenia treated with ovine Crotaline Fab fragments. This is the second reported case of venom-induced thrombocytopenia that followed a "biphasic" pattern with the inability of ovine Crotaline Fab fragments to prevent this toxic effect. This case shows that severe envenomation from Crotalus Helleri associated with a delayed presentation to the Emergency Department does not have a sustained response to the ovine antivenom, and suggests that the use of Wyeth (equine) antivenom may be of greater therapeutic benefit.

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Publisher Full Text

Authors+Show Affiliations

Wasserberger J
Medical Toxicology, 23206 Lyons Ave., Suite 104, Santa Clarita, California, USA.
Ordog G
No affiliation info available
Merkin TE
No affiliation info available

MeSH

AnimalsAntiveninsCrotalid VenomsCrotalusEmergency Medical ServicesHumansImmunoglobulin Fab FragmentsImmunoglobulin FragmentsMaleMiddle AgedSnake BitesThrombocytopeniaTime Factors

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16982358

Citation

Wasserberger, Jonathan, et al. "Southern Pacific Rattlesnake Bite: a Unique Clinical Challenge." The Journal of Emergency Medicine, vol. 31, no. 3, 2006, pp. 263-6.
Wasserberger J, Ordog G, Merkin TE. Southern Pacific Rattlesnake bite: a unique clinical challenge. J Emerg Med. 2006;31(3):263-6.
Wasserberger, J., Ordog, G., & Merkin, T. E. (2006). Southern Pacific Rattlesnake bite: a unique clinical challenge. The Journal of Emergency Medicine, 31(3), 263-6.
Wasserberger J, Ordog G, Merkin TE. Southern Pacific Rattlesnake Bite: a Unique Clinical Challenge. J Emerg Med. 2006;31(3):263-6. PubMed PMID: 16982358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Southern Pacific Rattlesnake bite: a unique clinical challenge. AU - Wasserberger,Jonathan, AU - Ordog,Gary, AU - Merkin,Terry E, PY - 2004/12/22/received PY - 2005/04/29/revised PY - 2005/09/05/accepted PY - 2006/9/20/pubmed PY - 2006/12/22/medline PY - 2006/9/20/entrez SP - 263 EP - 6 JF - The Journal of emergency medicine JO - J Emerg Med VL - 31 IS - 3 N2 - The Southern Pacific Coast Rattlesnake (Crotalus Helleri) is responsible for most of the snake bites in the coastal area of California from Los Angeles to San Diego. However, Crotalidae polyvalent immune ovine Fab fragments are not made from the venom of C. Helleri. This sheep-derived antivenom is indicated only in moderate snakebite envenomations. Very scant data are available regarding venom-induced thrombocytopenia treated with ovine Crotaline Fab fragments. This is the second reported case of venom-induced thrombocytopenia that followed a "biphasic" pattern with the inability of ovine Crotaline Fab fragments to prevent this toxic effect. This case shows that severe envenomation from Crotalus Helleri associated with a delayed presentation to the Emergency Department does not have a sustained response to the ovine antivenom, and suggests that the use of Wyeth (equine) antivenom may be of greater therapeutic benefit. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/16982358/Southern_Pacific_Rattlesnake_bite:_a_unique_clinical_challenge_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0736-4679(06)00431-8 DB - PRIME DP - Unbound Medicine ER -