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Crotalus viridis bite aftereffects?
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by viandy on October 18, 2003
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On 08.18 I received a very mild, almost dry, bite from a prairie rattler. I was in the hospital overnight, but didn't need antivemon, practically no tissue lost. Now, eight weeks later, the lymph nodes on both hips (inguinal?) are painfully swollen. Bloodwork has come back negative, my doctor doesn't have an answer to why this is happening. With no other significant events having occurred, I wonder if it might be an after effect of the bite. Also, I had a routine physical a week before the swelling started, and my doctor agrees that I wasn't swollen at that time, approx six weeks after the bite, that it began after that. Does this sound familiar to anyone? Responses appreciated.
Thanks,
Andy
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RE: Crotalus viridis bite after-effects?
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by Chris_Harper on October 19, 2003
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That is strange. Lymphangitis, lymphadenitis, and lymphadenopathy have been reported and are not uncommon after crotalid envenomations - about 40% of pt's (F.E.Russell 1980) I'm curious to know how long after the bite the lymph node pain started.
Considering the time since the bite, I would normally guess that your lymphadenitis was probably related to the administration of antivenom and is a Type III immune response. But since you didn't get any antivenom, it is probably related to the envenomation itself.
The bottom line is that crotalid envenomations can directly cause swollen lymph nodes. I just don't know exactly how long after the bite the symptoms can persist. Let me know when yours subside. Email me directly.
Chris Harper, NREMT-P
Webmaster@VenomousReptiles.org
PS - You probably need to see an immunologist to get some answers. I'm under the impression that your immune system was kicked into overdrive by this bite.
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RE: Crotalus viridis bite after-effects?
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by viandy on October 30, 2003
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The saga continues. Last Thursday I went to a "surgeon" (I don't mean that mockingly, but I don't
know what his specialty is). He had me on the table on Friday and took out the most swollen lymph node,
happened to be the left inguinal/femoral. He said afterward that he didn't think it was lymphoma,
but most likely cat scratch fever (I never want to hear those guitar chords again).
The biopsy came back today, it reads;
Frozen Section Diagnosis - Necrotizing lymphadenitis
Gross description -- Sectioning reveals no evidence of mass lesion or purulent material formation.
Microscopic examination - The left femoral lymph node contains a relatively intact low power
architecture but is largely replace by large accumulation of epithelioid histiocytes and occasional
giant cells with many central areas of a stellate type necrosis and infiltration by scattered segmented neutrophils.
the periphery of the necrotic appearing areas is composed primarily of epithelioid histiocytes without evidence of
convincing Reed-Sternberg cells. In other areas there are enlarged and irregular but benign appearing germinal centers with
evolving lymphocytic and immunoblastic cells associated with macrophages containing benign tingible
bodies. Special stains for acid fast bacilli and fungi are negative. There is no evidence of primary lymphoreticular
or metastatic epithelial malignancy.
Many of the individual words mean something to me, but as a whole it's a blur. I'm scheduled to see an infectious
disease specialist on monday. the surgeon seems to want it to be aids, asked me if I'm gay (no), when my last
aids test was (2001 -- None since then!?! -- Just entered my first relationship since then). Seeing "necrotizing"
made me think of crotalid venom, but I don't know if that's correct in this context. A friend could get me in contact
with Dean Ripa, but don't know if this is really his area( it may be, I just don't know). If you think it sounds related
to the bite and have anything I can reference for the doctor, please let me know. I would really appreciate it.
Andy
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