Envenomation from an eastern cottonmouth (Agkistrodon piscivorus). This man received a bite to the knee when he knelt down on the shore by his boat. The extent of swelling 3 hours after the bite is shown by the horizontal line on the lower thigh. Gravitational ecchymosis is denoted by the semicircular line inferiorly.
Reproduced with permission from Daniel E. Keyler, PharmD, FAACT.
Graphic 122497 Version 2.0
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