One Bite, Two Patients: Disparate Clinical Courses Following Simultaneous Crotalus oreganus abyssus Envenomation

Wilderness Environ Med. 2020 Sep;31(3):354-357. doi: 10.1016/j.wem.2020.05.004. Epub 2020 Aug 18.

Abstract

A number of crotaline species have been associated with neurotoxic envenomation in North America. One clinical sign that can occur is myokymia: fine, involuntary, wave-like muscle movements occurring at regular intervals. We report an unusual scenario in which a single snakebite resulted in simultaneous envenomation of 2 patients. Both developed myokymia, with 1 having respiratory compromise. One patient also developed a hypersensitivity reaction to antivenom. Envenomation by the Grand Canyon rattlesnake, Crotalus oreganus abyssus, can produce significant neurotoxicity and resultant respiratory compromise. Antivenom may be helpful but can produce hypersensitivity reactions.

Keywords: Grand Canyon rattlesnake; antivenom; myokymia; selfie.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Animals
  • Antivenins / adverse effects*
  • Arizona
  • Crotalid Venoms / toxicity*
  • Crotalus*
  • Humans
  • Hypersensitivity / etiology
  • Hypersensitivity / therapy*
  • Male
  • Middle Aged
  • Myokymia / etiology
  • Myokymia / pathology
  • Myokymia / physiopathology
  • Myokymia / therapy*
  • Snake Bites / complications
  • Snake Bites / pathology*
  • Snake Bites / physiopathology
  • Snake Bites / therapy*

Substances

  • Antivenins
  • Crotalid Venoms