Exotic snakebites reported to Pennsylvania poison control centers: lessons learned on the demographics, clinical effects, and treatment of these cases

Exotic snakebites are a rare occurrence but they present a unique challenge to clinicians treating these patients. Poison control centers are often contacted to assist in the management and care of these medical emergencies. In this study, we analyzed case records of the two Pennsylvania poison control centers from 2004-2018 to describe clinical features reported as a result of exotic snakebite envenomation. For the 15-year period reviewed, 18 exotic snakebites were reported with effects ranging from mild local tissue injury to patients who were treated with mechanical ventilation due to respiratory failure. The mean age of the patients was 35 years-old and males accounted for 88% of the cases. Antivenom, the only specific treatment, was administered in seven of 18 patients within an average of four hours of envenomation. The procurement of antivenom against these exotic specific may require substantial logistical efforts due to limited stocking of this rarely used treatment. Newer, targeted, small molecule treatments that are being currently investigated may aid in the treatment of snakebites in general. However, people should be cautious when handling these exotic species and clinicians should be aware of these bites and relevant clinical effects in order to manage these when reported