Intravascular hemolysis associated with North American crotalid envenomation.
This is a case of severe intravascular hemolysis, without significant coagulopathy, following envenomation by a North American crotalid. A MEDLINE search from 1966-1997, and a review of older literature, revealed no similar cases. A 4-year-old girl was envenomated in her right foot by a 2.5 foot-long rattlesnake whose description matched that of the Hopi rattlesnake (Crotalus viridis nuntius). The snake was not captured. Her initial hematocrit was 45%. In spite of treatment with antivenin and improvement in her lower extremity pain and swelling, her hematocrit decreased to 20.4%. Laboratory tests and clinical exam showed a Coombs positive hemolytic anemia without significant signs of coagulopathy.
Division of Emergency Medicine, University of Arizona College of Medicine, Tucson 85724-5057, USA. raquel@aemrc.arizona.edu
R L
RL
Gibly
F G
FG
Walter
S W
SW
Nowlin
R A
RA
Berg
D000743:Anemia, Hemolytic / Q000139:chemically induced*; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002675:Child, Preschool; D003435:Crotalid Venoms / Q000009:adverse effects*; D005260:Female; D006400:Hematocrit; D006461:Hemolysis / Q000187:drug effects*; D006801:Humans; D012909:Snake Bites / Q000209:etiology* / Q000628:therapy; D017819:Viperidae
D000997:Antivenins; D003435:Crotalid Venoms