Canebrake rattlesnake envenomation

Area of Science:

• Toxicology
• Herpetology
• Clinical Medicine

Background:

• Canebrake rattlesnake (Crotalus horridus atricaudatus) envenomation presents unique clinical challenges.
• Understanding the specific effects of C. h. atricaudatus venom is crucial for effective patient management.

Observation:

• Retrospective review of 15 consecutive cases of C. h. atricaudatus envenomation.
• Detailed analysis of clinical presentation, coagulation, serum enzymes, ECG findings, and antivenom treatment.
• Envenomation severity ranged from mild to severe, with one fatality.

Findings:

• Rhabdomyolysis, indicated by elevated serum creatinine kinase (CK) levels, is a characteristic finding.
• Elevated CK levels primarily originate from skeletal muscle, not cardiac muscle, despite CK-MB fraction increases.
• Clinical course severity correlated with CK levels and antivenom requirements.

Implications:

• Physicians should recognize elevated CK in C. h. atricaudatus envenomation as indicative of rhabdomyolysis.
• Prompt medical support and timely antivenom administration are vital for managing moderate to severe cases.
• Further research into C. h. atricaudatus venom toxins may elucidate mechanisms of rhabdomyolysis.