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This case highlights the need for clinicians to maintain a high level of suspicion for snakebite envenomation in cases without a witnessed snakebite.<\/jats:p>","DOI":"10.1136\/bcr-2025-270770","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:20:25Z","timestamp":1784730025000},"page":"e270770","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unwitnessed rattlesnake envenomation: a difficult diagnosis"],"prefix":"10.1136","volume":"19","author":[{"given":"Ethan","family":"Schlam","sequence":"first","affiliation":[{"name":"Dermatology, University of Arizona Medical Center - University Campus, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6698-5858","authenticated-orcid":false,"given":"Andrew","family":"Roth","sequence":"additional","affiliation":[{"name":"Dermatology, University of Arizona Medical Center - University Campus, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-0203","authenticated-orcid":false,"given":"Jonathan Warren","family":"Meadows","sequence":"additional","affiliation":[{"name":"Emergency Medicine, University of Arizona Medical Center - University Campus, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Hiatt","sequence":"additional","affiliation":[{"name":"Dermatology, University of Arizona Medical Center - University Campus, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Fazel","sequence":"additional","affiliation":[{"name":"Dermatology, University of Arizona Medical Center - University Campus, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"2026072207201452000_19.7.e270770.1","unstructured":"World Health Organization . 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