MOJAVE RATTLESNAKE ENVENOMATION IN SOUTHERN CALIFORNIA - A REVIEW OF SUSPECTED CASES

To clarify whether Mojave rattlesnake (Crotalus scutulatus scutulatus) envenomations occurring in California cause typical crotalid tissue e ffects, pain, edema, and ecchymosis, we reviewed charts of snakebite v ictims at a tertiary care teaching hospital and a moderate-size commun ity hospital. Forty-two patients were bitten within the range of Mojav e rattlesnakes. Eight snakes were identified as Mojave rattlesnakes (g roup 1); of these, four were confirmed by experts in snake identificat ion (group 1a). Fifteen patients were reported bitten by other rattles nake species (group 2), and in 19 envenomations the species was unknow n (group 3). Seventy-five percent of patients in group 1 were reported to have local edema at the envenomation site compared with all of the patients in group 2. Ecchymosis was found in 25% of group 1 patients and 73% of group 2 patients. Pain was documented in only 12% of group 1 and 67% of group 2 victims. Neurotropic events, many severe, were fo und in 75% of group 1 patients compared with 7% of those in group 2. A lthough this study does not have the power to justify statistical eval uation, C. scutulatus envenomations do appear inclined to less tissue reaction. A disturbing trend toward severe neurotropic manifestations was also suggested in presumed Mojave rattlesnake envenomations.