# Bide Your Time With Bites: A Case of Rattlesnake Envenomation in Pennsylvania

## TL;DR

A man bitten by a western diamondback rattlesnake in Pennsylvania initially had mild symptoms but later required antivenom after his condition worsened.

## Contribution

This case highlights the need for clinician education on envenomation management, even in regions without native venomous snakes.

## Key findings

- Initial symptoms were mild with normal coagulation studies, leading to no antivenom use.
- The patient's condition worsened 12 hours later, requiring antivenom and hospital transfer.
- Symptoms resolved after additional antivenom administration.

## Abstract

This case report represents a 26-year-old male with no significant past medical history who presented to the emergency department in western Pennsylvania following a western diamondback rattlesnake (Crotalus Atrox) bite to his hand. His initial swelling was mild, and his coagulation studies were unremarkable, with minimal changes on repeat studies, and poison control recommended against antivenom administration. He was discharged home with oral antibiotics and analgesics due to his stable clinical course. However, he returned to the emergency department about 12 hours later with worsening pain and swelling that extended to his elbow. He was then given antivenom and transferred to a larger center for higher-level care, ultimately having symptom resolution after further antivenom administration. This report serves to underline the importance of clinician education regarding envenomation management throughout the United States, including areas without indigenous venomous snakes.