Invited Commentary

Commentary on “Epidemiology of the Reported Severity of Cottonmouth (Agkistrodon piscivorus) Snakebite”

Authors: David L. Morgan, MD, MS, Jason Collins, MD

Abstract

In this issue of the Southern Medical Journal, Walter and colleagues have reviewed trends of cottonmouth (Agkistrodon piscivorus) snakebite severity as reported in the annual reports of the American Association of Poison Control Centers.1, The stated goal of the study was to examine medical outcomes of these snakebites 18 years before and 11 years after the currently used antivenom that was introduced in 2001.1 All North American pit viper snakes (rattlesnakes, cottonmouths, and copperheads) may cause envenomations with potential morbidity and mortality.2 Cottonmouths live predominantly in the southeastern United States, from the east coast to central Texas. Many patients believe cottonmouths (also known as water moccasins) are particularly ferocious compared with the other pit vipers.3

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References

1. Walter FG, Stolz U, Shirazi F, et al. Epidemiology of the reported severity of cottonmouth (Agkistrodon piscivorus) snakebite. South Med J 2014;107:150-156.
 
2. Gold BS, Barish RA, Dart RC. North American snake envenomation: diagnosis, treatment and management. Emerg Med Clin North Am 2004;22:423-443.
 
3. Gibbons JW, Dorcas ME. Defensive behavior of cottonmouths (agkistrodon piscivorus) toward humans. Copeia 2002;1:195-198.
 
4. Lavonas EJ, Ruha AM, Banner W, et al. Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop. BMC Emerg Med 2011;11:2.
 
5. CroFab [prescribing information]. Brentwood, TN, BTG International, 2010.
 
6. Spiller HA, Griffith JR. The value and evolving role of the U.S. Poison Control Center system. Public Health Rep 2004;124:359-363.