title: Is the Puerto Rican racer, Alsophis portoricensis, really harmless? A case report series.
abstract: Puerto Rico (PR) is home to 10 indigenous species of snake. Alsophis portorricensis has traditionally been considered harmless. In 1961, Hageman classified A portorricensis as somewhere between "venomous" and "nonvenomous." In 1966, Heatwole and Banuchi reported the only case found in the literature of a "venomous" bite from Alsophis portorricensis. Only 6 cases of snakebite were reported to the PR Department of Health from 1998 to 2007; ecchymosis, swelling, and abnormal vital signs were noted in all of the cases. In 5 of these 6 cases, the captured snake was, in fact, identified as Alsophis portorricensis of the Colubridae family; in the remaining case, the description strongly suggests that it was the same species as the others. All bites were inflicted on fingers, which were presented for evaluation from 2 to 24 hours after the event. All documented cases report that the bite lasted from 1 to 4 minutes. All of the victims presented with localized pain and ecchymosis. Localized edema extended from the hand to the elbow in 4 cases, and up to the shoulder in 2 cases. All patients were treated symptomatically, observed at the Emergency Department (ED), and discharged home within 24 hours after the ED evaluation. All patients reported the resolution of symptoms within 1 week. Traditionally, PR has not been associated with any dangerous species of snake. These cases show that the second most abundant snake on the island can inflict a venomous bite, with local and systemic symptoms that warrant adequate preparation by the medical community.
authors.affiliation: Department of Emergency Medicine, Hospital San Lucas, Ponce School of Medicine, Ponce, Puerto Rico.
authors.forename: Carlos
authors.initials: C
authors.lastname: García-Gubern
authors.forename: Raúl
authors.initials: R
authors.lastname: Bello
authors.forename: Victor
authors.initials: V
authors.lastname: Rivera
authors.forename: Angel
authors.initials: A
authors.lastname: Rocafort
authors.forename: Lissandra
authors.initials: L
authors.lastname: Colon-Rolon
authors.forename: Hector
authors.initials: H
authors.lastname: Acosta-Tapia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000818:Animals; D017812:Colubridae; D004438:Ecchymosis / Q000209:etiology; D004487:Edema / Q000209:etiology; D004636:Emergency Service, Hospital; D005383:Finger Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005392:First Aid; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D011647:Puerto Rico; D012909:Snake Bites / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012910:Snake Venoms / Q000506:poisoning*; D055815:Young Adult
chemical_list: D000700:Analgesics; D012910:Snake Venoms