Recurrence phenomena after immunoglobulin therapy for snake envenomations: Part 2. Guidelines for clinical management with crotaline Fab antivenom
Related Experiment Video
Updated: Oct 9, 2026

Captive Maintenance and Venom Extraction of Tityus serrulatus (Brazilian Yellow Scorpion) for Antivenom Production
Published on: October 6, 2023
L V Boyer1, S A Seifert, J S Cain
1Department of Pediatrics and Arizona Poison and Drug Information Center, University of Arizona Health Sciences Center, Tucson, AZ 85724, USA. boyer@pharmacy.arizona.edu
Abstract:
Recurrent local and coagulopathic effects (worsening after clinical improvement) have been described after treatment with Fab antivenom for envenomation by North American crotaline snakes. Although similar phenomena have been described previously in snakebite, few studies have examined recurrence or its management. Recurrence is consistent with known venom and antivenom kinetics and dynamics. The clinical significance of late coagulopathy after snakebite is uncertain, but clinically significant bleeding is a possibility. Prevention and treatment of recurrence with Fab antivenom require repeated dosing for at least 18 hours, with close monitoring of at-risk patients in the follow-up period. Duration of therapy depends on individual risk factors and coagulation response.
Related Concept Videos
Prevention of Further Absorption of Poison
Cross-reactivity
Venous Thrombosis III: Interprofessional Care
Myocarditis III: Medical Management
Pharmaceutical Poisoning: Treatment Strategies
Nephrotic Syndrome II : Assessment and Medical Management
