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We report an envenomation by the African puff adder (Bitis arietans), an exotic snake in the United States. The patient developed swelling and ecchymoses in the affected extremity, and cutaneous necrosis of the envenomated fingertip. There was no significant coagulopathy. He received 20 vials of specific antivenin (Schlangengift-Immunserum Behring Zentralafrika, Behringwerke, Marburg, Germany)...
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