@article{ref1,
title="Compartment syndrome after South American rattlesnake (Crotalus durissus terrificus) envenomation",
journal="Clinical toxicology (Philadelphia, Pa.)",
year="2014",
author="Bucaretchi, F. and De Capitani, E. M. and Hyslop, S. and Mello, S. M. and Fernandes, C. B. and Bergo, F. and Nascimento, F. B. P.",
volume="52",
number="6",
pages="639-641",
abstract="Context. In order to report the outcome of a patient who developed compartment syndrome after South American rattlesnake (Crotalus durissus terrificus) envenomation, confirmed by subfascial pressure measurement and magnetic resonance imaging (MRI). Case details. A 63-year-old male was admitted 1 h after being bitten on the right elbow by a &quot;large&quot; snake, which was not brought for identification. Physical and laboratory features upon admission revealed two fang marks, local tense swelling, paresthesia, intense local pain, hypertension, coagulopathy, and CK = 1530 U/L (RV < 170 U/L). The case was initially treated with bothropic antivenom (80 mL, intravenously), with no improvement. Evolution within 13-14 h post-bite revealed generalized myalgia, muscle weakness, palpebral ptosis, and severe rhabdomyolysis (CK = 126,160 U/L) compatible with envenoming by C. d. terrificus. The patient was then treated with crotalic antivenom (200 mL, intravenously), fluid replacement, and urine alkalinization. Twenty-four-hour post-bite MRI showed marked muscular edema in the anterior compartment of the right forearm, with a high subfascial pressure (40 mmHg) being detected 1 h later. ELISA of a blood sample obtained upon admission, before antivenom infusion, revealed a high serum concentration of C. d. terrificus venom. No fasciotomy was performed and the patient was discharged seven days later without sequelae. <br><br>CONCLUSION. Snakebite by C. d. terrificus with subfascial venom injection may lead to increased intracompartmental pressure.<p /> <p>Language: en</p>",
language="en",
issn="1556-3650",
doi="10.3109/15563650.2014.913177",
url="http://dx.doi.org/10.3109/15563650.2014.913177"
}