title: Southern Pacific Rattlesnake bite: a unique clinical challenge.
abstract: The Southern Pacific Coast Rattlesnake (Crotalus Helleri) is responsible for most of the snake bites in the coastal area of California from Los Angeles to San Diego. However, Crotalidae polyvalent immune ovine Fab fragments are not made from the venom of C. Helleri. This sheep-derived antivenom is indicated only in moderate snakebite envenomations. Very scant data are available regarding venom-induced thrombocytopenia treated with ovine Crotaline Fab fragments. This is the second reported case of venom-induced thrombocytopenia that followed a "biphasic" pattern with the inability of ovine Crotaline Fab fragments to prevent this toxic effect. This case shows that severe envenomation from Crotalus Helleri associated with a delayed presentation to the Emergency Department does not have a sustained response to the ovine antivenom, and suggests that the use of Wyeth (equine) antivenom may be of greater therapeutic benefit.
authors.affiliation: Medical Toxicology, 23206 Lyons Ave., Suite 104, Santa Clarita, California, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wasserberger
authors.forename: Gary
authors.initials: G
authors.lastname: Ordog
authors.forename: Terry E
authors.initials: TE
authors.lastname: Merkin
mesh_terms: D000818:Animals; D000997:Antivenins / Q000494:pharmacology*; D003435:Crotalid Venoms / Q000009:adverse effects*; D017839:Crotalus; D004632:Emergency Medical Services; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012909:Snake Bites / Q000097:blood / Q000628:therapy*; D013921:Thrombocytopenia / Q000209:etiology* / Q000628:therapy; D013997:Time Factors
chemical_list: D000997:Antivenins; D003435:Crotalid Venoms; C431183:Crotalidae Polyvalent immune Fab; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments