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Pediatr Emerg Care ; 29(11): 1213-6, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24196093

RESUMEN

The timber rattlesnake, also known as Crotalus horridus, is well known to cause significant injury from toxins stored within its venom. During envenomation, toxic systemic effects immediately begin to cause damage to many organ systems including cardiovascular, hematologic, musculoskeletal, respiratory, and neurologic. One defining characteristic of the timber rattlesnake is a specific neurotoxin called crotoxin, or the "canebrake toxin," which is a potent ß-neurotoxin affecting presynaptic nerves that can cause paralysis by inhibiting appropriate neuromuscular transmission. We present an unusual case of an 8-year-old boy bitten twice on his calf by a timber rattlesnake, who presented with a life-threatening envenomation and suffered multisystem organ failure as well as a prominent presynaptic neurotoxicity resulting in facial diplegia, pharyngeal paralysis, and ophthalmoplegia.


Asunto(s)
Venenos de Crotálidos/envenenamiento , Crotalus , Parálisis Facial/etiología , Oftalmoplejía/etiología , Parálisis/etiología , Enfermedades Faríngeas/etiología , Mordeduras de Serpientes/complicaciones , Animales , Antivenenos/uso terapéutico , Niño , Terapia Combinada , Venenos de Crotálidos/farmacología , Crotoxina/farmacología , Crotoxina/envenenamiento , Difenhidramina/uso terapéutico , Urgencias Médicas , Epinefrina/uso terapéutico , Humanos , Fragmentos Fab de Inmunoglobulinas/uso terapéutico , Infusiones Intraóseas , Masculino , Metilprednisolona/uso terapéutico , Insuficiencia Multiorgánica/etiología , Insuficiencia Multiorgánica/terapia , Unión Neuromuscular/efectos de los fármacos , Plasma , Terminales Presinápticos/efectos de los fármacos , Respiración Artificial , Rabdomiólisis/etiología , Mordeduras de Serpientes/terapia
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