Envenomation by a wild Guatemalan Beaded Lizard Heloderma horridum charlesbogerti.

BACKGROUND

The Guatemalan Beaded Lizard (Heloderma horridum charlesbogerti) is an endemic venomous lizard that inhabits southeastern Guatemala. Published reports of bites by Beaded Lizard are scarce. This is the first case report of a bite from Heloderma horridum charlesbogerti.

CASE REPORT: A 24-year-old man was bitten on the left hand by a juvenile Heloderma horridum charlesbogerti. The lizard remained attached for approximately 15 seconds. The patient experienced severe local pain, dizziness, diaphoresis, vomiting, severe paresthesia in his left hand and arm, and hypotension (70/52 mm/Hg). He was treated with intravenous ketorolac, chlorpheniramine, methylprednisolone, antibiotics, ondansentron, and normal saline. Hematology tests revealed leukocytosis (12,600/mm3). Symptoms improved and the patient was discharged from hospital 24 hours after admission.

CONCLUSION

The case reported here shows that bites by Heloderma produce severe clinical effects shortly after the bite. Management consists of waiting for the lizard to relax its bite pressure and using pliers to open lizard's mouth and pull out the bitten extremity, a careful manual search for teeth remnants, and supportive care. In our case, severe pain, unresponsive to non-steroidal anti-inflammatory analgesics, was a major problem. Parethesias resolve quickly but pain may persist for up to 12 hours after the bite. A full recovery is expected.