title: Long-term complications of rattlesnake bites: a telephone survey from Central California.
abstract: OBJECTIVE
  The purpose of this institutional review board-approved, cross-sectional study was to identify residual symptoms and signs of envenomation reported by snakebite survivors via a telephone survey.
  
  
  METHODS
  Victims of rattlesnake bite who were treated at a single hospital center during a 10-year period were contacted through a telephone survey. Study subjects were included through a diagnosis-based retrospective chart review of snakebite victims, and excluded if they did not receive rattlesnake antivenom. Data collection was done using a standardized form that included sections about residual, recurrent, or new pain, weakness, paresthesias, or other limitations of the bitten limb.
  
  
  RESULTS
  We identified 46 snakebite cases including 5 of 46 "dry" bites. The remaining cases (41 of 46) all received Crofab. Interviews were completed for 31% of these patients (13 of 41), and the remainder were lost to follow-up. Most bites occurred in men (12 cases, 92% males) and on the arms (9 cases, 69%). Six of the 13 respondents (46%) reported residual symptoms from the bite. Persistent symptoms described included localized pain at the bite site (3 cases), numbness or paresthesias (2 cases), abnormal skin peeling and discoloration at the bite site (2 cases), and persistent weakness of the bitten extremity (1 case). Among patients reporting persistent symptoms, the bite-to-survey interval ranged from 7 months to 12 years, with a median interval of 4 years.
  
  
  CONCLUSIONS
  Our study population demonstrated a notable incidence (43%) of self-reported persistent symptoms related to their rattlesnake bites, although the overall level of disability from these injuries seems low.
authors: Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Fresno, CA. Electronic address: sspano@gmail.com.
authors: Susanne J
authors: SJ
authors: Spano
authors: Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Fresno, CA.
authors: Rais
authors: R
authors: Vohra
authors: Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Fresno, CA.
authors: Fernando
authors: F
authors: Macias
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D017839:Crotalus; D005260:Female; D006306:Health Surveys; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008297:Male; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012909:Snake Bites / Q000150:complications* / Q000188:drug therapy; D013689:Telephone
chemical_list: D000997:Antivenins; C431183:Crotalidae Polyvalent immune Fab; D007140:Immunoglobulin Fab Fragments
keywords: central California; complex regional pain syndrome; envenomations; long-term complications; reflex sympathetic dystrophy); snakebite