The patient sustained a snake bite to his right index finger with significant edema and pain extending to his right wrist. Several areas of swelling were marked on the patient’s skin with timestamps and originally were contained to the dorsum of the hand. Labs were without abnormality, and the patient was not hypotensive.
The edema spread proximally to the right wrist and Crotalidae polyvalent immune fab (CroFab) was administered per hospital guidelines (six vials initially). The patient made a full recovery and was discharged home forty-eight hours after.
- Cottonmouth snakes appear differently as juveniles; however, they are part of the subfamily Crotalinae and envenomation can still occur with significant symptoms.
- CroFab should be administered for hypotension, altered mental status, the progression of swelling beyond bite site, or significant laboratory abnormalities including thrombocytopenia, elevated INR, or fibrinogen less than one hundred mg/dL .