Abstract
A 16-year-old male was evaluated in the Emergency Department for a rattlesnake bite on the left calf. He was released following 6 h of observation, as recommended in standard references, without complaints or objective criteria present to indicate envenomation. The patient returned 36 h later complaining of severe pain at the bite site and showing objective evidence for systemic envenomation. He was successfully treated for crotalid envenomation with antivenin. This case demonstrates that initial systemic signs and symptoms may begin more than 6 h after crotalid envenomation. Therefore, we recommend that snake bite care must be coupled with close outpatient follow-up for 24 h.
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