A rare case of multiple rattlesnake bites

The rattlesnake (Crotalus adamanteus) is a venomous viper inhabiting the southeastern parts of the United States. It is not found in the Balkans and Europe habitats. Subjects of the species are grown and seen in museums, exhibitions and terrariums, and sometimes in private collections. This may generate potentially toxic exposures to the venom in accidental contact. Acute poisoning with rattlesnake poison in Bulgaria is exotic, rare and even casuistic. The venom of the rattlesnake exhibits neuropathic, proteolytic and hemolytic activities. Antivenom is not currently easily available in Bulgaria--it is not usually stored in hospitals because it is very rarely used and therefore rather expensive. We present a case of multiple envenomation (two different occasions) of one and the same person who kept rattlesnakes in a private terrarium. Local toxic syndrome was observed with burning and stinging pain at bite site combined with limited hemorrhage and necrosis. The hemolytic reaction and the local toxic results were successfully managed without resorting to any specific antidotal therapy.