RATTLESNAKE BITE COMPLICATIONS IN 19 CHILDREN

The Western diamondback rattlesnake, Crotalus atrox, is responsible fo r the majority of snakebites in Sonora, Mexico. We report 19 cases of children who were attacked by these snakes. Most of the rattlesnake at tacks occurred in rural areas during the summer. The children's ages r anged from one to 15 years. The lower extremities, especially the legs , were most often bitten. The signs and symptoms presented by these pa tients included: pain, edema, limitation of motion, ecchymosis, bleedi ng and necrosis in the area of the bite, epistaxis, hematuria, and vom iting. Hospital treatment included: parenteral electrolyte solutions, antivenom serum, antibiotics, tetanus toxoid, blood transfusions, hydr ocortisone, heparin, and peritoneal dialysis. In one case a fasciotomy was necessary. The observed complications on envenomations included: hemolysis, local necrosis, coagulation disorders, paresthesia, somnole nce, and acute renal failure. One death occurred from disseminated int ravascular coagulation.