Airway obstruction following canebrake rattlesnake envenomation

We report an unusual case of canebrake rattlesnake (Crotalus horridus atricaudatus) envenomation whose major manifestation was orolingual edema and airway compromise. The likely source of swelling was mucosal absorption of venom following the first aid technique of cutting and sucking the bite site. Except for airway compromise, the patient had mild local bite site effects (swelling) and mild systemic findings (depressed fibrinogen and elevated creatinine phosphokinase). He was managed with fiberoptic nasotracheal intubation and Crotalid antivenin with good outcome.