Lizard Envenomation Clinical Presentation

Updated: Jun 15, 2018
  • Author: Robert L Norris, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Presentation

History

The vast majority of individuals who are bitten by Gila monsters or beaded lizards are intentionally interacting with the animals, and the history of the bite usually is clear.

To help estimate the severity of envenomation, it is important to estimate the length of time the lizard remained attached to the victim. While an effective envenomation can occur with a contact time of a few seconds, if the lizard manages to hang on for a period of minutes, the bite could be very serious, potentially lethal.

The victim may present with many signs and symptoms, including the following:

  • Multiple lacerations that may bleed profusely

  • Severe throbbing or burning pain at the bite site that may radiate proximally

  • Discoloration at the bite site (eg, cyanosis, ecchymosis)

  • Generalized weakness

  • Nausea and vomiting

  • Shortness of breath

  • Sweating

  • Numbness

  • Dizziness

  • Faintness

  • Progressive edema

  • Painful lymph nodes

  • Angioedema

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Physical Examination

Vital signs should be assessed and closely monitored.

Local signs are as follows:

  • Multiple bleeding lacerations

  • Edema

  • Cyanosis or ecchymosis

  • Vasospasm

  • Retained teeth (Closely examine wounds and probe for foreign bodies.)

  • Necrosis (rare)

Systemic signs are as follows:

  • Tachycardia

  • Hypotension

  • Respiratory distress

  • Diaphoresis

  • Lymphangitis and lymphadenopathy

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Complications

Any of the attendant complications of shock may be encountered.

Myocardial infarction may occur.

Coagulopathy is a rare complication.

Wound infections may occur, especially in the setting of a retained tooth.

Necrosis is notably rare.

Allergic or anaphylactic reactions are also rare, but have been described. [5]

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