Complex Regional Pain Syndrome Developing After a Coral Snake Bite: A Case Report

Division

North Florida

Hospital

Ocala Regional Medical Center

Document Type

Case Report

Publication Date

8-16-2020

Keywords

complex regional pain syndrome, snake bite, gabapentin, budapest criteria, physical therapy

Disciplines

Internal Medicine | Therapeutics

Abstract

Complex regional pain syndrome (CRPS) usually occurs after an inciting injury. Poor understanding of pathophysiology, management, and disease awareness has led to misdiagnosis of this condition. We report a rare case of a 69-year-old male who developed CRPS following a Florida Coral snake bite on his right foot. Initially, it was misdiagnosed as recurrent cellulitis; however, he developed chronic right lower extremity (RLE) pain with worsening flares associated with right leg swelling and erythema. Examination was remarkable for nonpitting edema, erythema, and severe tenderness to light touch of the RLE, all symptoms that highly supported the diagnosis of CRPS. Treatment was initiated and consisted of physical therapy in addition to gabapentin which resulted in marked improvement. CRPS remains a challenging diagnosis due to lack of gold standard test and can be easily misdiagnosed. Clinical evaluation applying Budapest criteria can aid with diagnosis and should be routinely used for all patients with suspected CRPS.

Publisher or Conference

Cureus

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