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Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
North America
 
Mexico and Central America
 
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The Far East
 
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Clinic

 

Crotalus polystictus

Case reports

C. polystictus
Mexico
Hardy 1982: 1 case; identification morphological.

Signs & symptoms

Local effects

Mild local pain; rapidly progressive swelling, ecchymosis; blistering within 3 days; necrosis (1 cm2) (Hardy 1982).

Neurological effects

Fasciculations of the musculature of the hand and finger of the bitten extremity; hypaesthesia of the hands, feet and face; metallic taste (Hardy 1982).

Morbidity

Necrosis (Hardy 1982).

Laboratory and physical investigations

1. Haemostasis
Type of haemostatic defect
Defibrin(ogen)ation. Platelet aggregation (Hardy 1982).

Haemostatic parameters


Overview haemostasis
                 
B
 
                      
 
 H CT (FSP) Tc PT aPTT TT I FSP D II V VIII X XIII PC ATIII PI tPA α2AP
       
 
C
      
 
A
                        
 

Essential

bed-side

tests

 Tests for full clinical assessment Tests for research purposes
H haemorhagic effects
+ definite evidence in
human envenoming
CT full blood clotting test
(FSP)  FSP rapid test
Tc platlets
PT prothrombin time
aPTT partial thromboplastin time
TT thrombin time
I fibrinogen
FSP  fibrinogen split products
D D-dimer
II, V, VII, X, XIII
  clotting factors
PC protein C
ATIII antithrombin III
PI plasminogen
tPA tissue plasmin activator
α2AP α2-antiplasmin
 
In this overview, the deviations from normal
are recorded for those haemostasis para-
meters only, for which good evidence is
documented in the literature.

 

A Fibrinogen: serial measurements showed a clear decrease (and renewed increase coinciding with antivenom administration) (Hardy 1982).
B FSP: maximum 160 μg/ml (normal 2–10 μg/ml) (Hardy 1982).
C Platelets: minimum 145,000/mm³ (normal >150,000/mm³) (Hardy 1982).

Treatment (specific)

 

Antivenoms

1. Crotalidae Polyvalent Immune Fab Antivenom, ovine (immunized with Crotalus adamanteus, Crotalus atrox, Crotaus scutulatus ssp. and Agkistrodon piscivorus) / CroFab™, Savage Laboratories, Melville, New York

 

see Crotalus sp.

 


2. Wyeth antivenom (Crotalidae), polyvalent, Philadelphia, USA (no longer in use)

Efficacy

  1. With regard to neurological symptoms (see above): 5 vials of Wyeth antivenom (Crotalidae): symptoms disappeared simultaneously with antivenom administration (Hardy 1982).
  2. With regard to the haemostatic effect: 5 vials of Wyeth antivenom (Crotalidae): no progression of an incipient haemostatic defect (see above) coinciding with antivenom administration (Hardy 1982).