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Previous Volume 336:1262-1263 April 24, 1997 Number 17 Next

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To the Editor: The development of coagulation defects and associated hemorrhagic complications after envenomation from a crotalid (pit viper) has been well described.^1,2 Common manifestations include ecchymosis and oozing, hypofibrinogenemia, thrombocytopenia, and disseminated intravascular coagulation.^2,3,4,5 After an envenomating snakebite, venom is thought to travel primarily through the lymphatic system.

We recently evaluated a patient with an unusual hemorrhagic manifestation of crotalid envenomation that appears to be related to the lymphatic drainage of venom and venom-induced bleeding.

While rock climbing barefoot, a 26-year-old man was bitten on the toe by a snake that he saw and identified as a copperhead. He . . . [Full Text of this Article]

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