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A case of severe systemic copperhead (Agkistrodon contortrix) envenomation with shock

Year: 2025

Type: article

Abstract: We report a case of severe systemic copperhead ( Agkistrodon contortrix ) envenomation presenting with shock and minimal initial tissue injury. The patient required intravenous fluid resuscitation and a vasopressor infusion but improved with administration of high doses of Fab antivenom. He had resolution of his hypotension with antivenom, and his tissue injury progressed beyond his entire arm. He eventually stabilized with further antivenom and was discharged. Although A. contortrix envenomations are not typically severe, this case demonstrates that these bites can present with severe systemic clinical manifestations. Clinicians should focus on the management of the individual patient rather than determining therapy based solely on the offending species. • Severe systemic toxicity in Agkistrodon contortrix (copperhead) envenomations is uncommon. • Progressive tissue injury followed a verified copperhead snakebite with severe systemic symptoms and shock. • The patient's systemic symptoms stabilized with antivenom therapy. • Local tissue injury lagged the systemic toxicity.

Source: Toxicon

DOI: 10.1016/j.toxicon.2025.108361

Authors: Hayley Naasz, Santiago Cantillo-Campos, Kyle Steinbock, Andrew W. Godfrey, Charles J. Gerardo