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

Elis M. Cruz Salcedo, HCA Healthcare
Anamarys Blanco, HCA Healthcare
Justin Reed, HCA Healthcare


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.