• Andrew M King, William S Crim, Nathan B Menke, and Anthony F Pizon.
• Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh Medical Center, PUH South Tower, Suite M2935, Pittsburgh, PA 15213, USA. kingam@upmc.edu
• Toxicon. 2012 Dec 1; 60 (7): 1287-9.

UnlabelledDocumented envenomations by the pygmy rattlesnake (Sistrurus miliarius barbouri) are rare. While there have been no documented fatalities, several older case reports describe significant morbidity. We describe the first known case of pygmy rattlesnake envenomation that was treated with Crotalidae Polyvalent Immune Fab Antivenom (CroFab®).CaseA 28-year-old man with no significant past medical history presented after being envenomated on the right hand by his friend's pet pygmy rattlesnake. He developed swelling and pain in his hand and forearm. He responded well to a ten vial loading dose and a 18 h maintenance protocol of CroFab and was discharged the following day without developing any hematological or electrolyte derangements.ConclusionThis is the first documented use of CroFab for S. m. barbouri envenomation. The outcome of this case suggests that CroFab is a safe treatment modality in this setting.Copyright © 2012 Elsevier Ltd. All rights reserved.

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