Severe Toxicity From Crotalid Envenomation After Early Resolution of Symptoms

Initial observation of a patient who sustained a rattlesnake bite on the hand showed resolution of mild swelling over 3 hours. The patient left the emergency department against medical advice, only to return 12 hours later with severe pain and swelling, as well as a marked coagulopathy. This case illustrates the need for an observation period after crotalid bite, even when the envenomation seems to be minor or when symptoms resolve. [Guisto JA: Severe toxicity from crotalid envenomation after early resolution of symptoms. Ann Emerg Med September 1995;26:387-389.].