Lizard Envenomation Clinical Presentation

Updated: Oct 27, 2015
  • Author: Robert L Norris, MD; Chief Editor: Joe Alcock, MD, MS  more...
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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


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