Heise Craig William, Cunningham Cody, Ruha Anne-Michelle, O'Connor Ayrn D
Division of Medical Toxicology and Precision Medicine, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ; Department of Medical Toxicology, Banner - University Medicine Center Phoenix, Phoenix, AZ.
Mayo Clinic Alix School of Medicine, Phoenix, AZ.
Wilderness Environ Med. 2020 Sep;31(3):354-357. doi: 10.1016/j.wem.2020.05.004. Epub 2020 Aug 18.
A number of crotaline species have been associated with neurotoxic envenomation in North America. One clinical sign that can occur is myokymia: fine, involuntary, wave-like muscle movements occurring at regular intervals. We report an unusual scenario in which a single snakebite resulted in simultaneous envenomation of 2 patients. Both developed myokymia, with 1 having respiratory compromise. One patient also developed a hypersensitivity reaction to antivenom. Envenomation by the Grand Canyon rattlesnake, Crotalus oreganus abyssus, can produce significant neurotoxicity and resultant respiratory compromise. Antivenom may be helpful but can produce hypersensitivity reactions.
在北美，多种响尾蛇物种与神经毒性蛇咬伤有关。可能出现的一种临床症状是肌束震颤：即有规律间隔出现的细微、不自主、波浪状肌肉运动。我们报告了一个不寻常的案例，单次蛇咬伤导致两名患者同时中毒。两人都出现了肌束震颤，其中一人有呼吸功能不全。一名患者还对抗蛇毒血清产生了过敏反应。大峡谷响尾蛇（学名：Crotalus oreganus abyssus）咬伤可产生显著的神经毒性并导致呼吸功能不全。抗蛇毒血清可能有帮助，但也可能产生过敏反应。
