A Bite by a Beaded Lizard, Heloderma spp. (Helodermatidae), Resulting in Local Envenomation and Boutonnière Deformity

Beaded lizards (Heloderma spp) are venomous lizards capable of inflicting local and systemic envenoming. An exotic pet collector presented with a reportedly prolonged bite by a presumed Guatemalan beaded lizard (Heloderma charlesbogerti). He reported immediate symptoms of envenoming, including severe pain, paresthesia, local swelling, dizziness, and nausea. Follow-up assessments conducted over a period of up to 4 y revealed a persistent boutonnière deformity of the right middle finger. This case report describes envenomation caused by the uncommonly documented bite of a beaded lizard (Heloderma spp) that was presumed by the patient to be the rare Guatemalan beaded lizard (H charlesbogerti). It illustrates the risks of long-term sequelae that may result from noncompliance with treatment after a helodermatid bite and also reemphasizes concerns about the underground sale of rare, endangered wildlife. Beaded lizard bites can inflict severe local envenomation and potentially cause permanent hand deformities. Proper referral and follow-up are essential to prevent long-term sequelae.