"There was swelling, and some bleeding deep in the tissues," said Dr. Hartmut Gross, a Medical College of Georgia emergency medicine physician.
The patient was from Burke County, where he had been bitten just above the ankle by a venomous snake.
"The suspicion was that it was a cottonmouth," Gross said.
After treatments with antivenin and a stay in the intensive care facility, the child is much better.
"We actually had two come in that same evening, and both were children," Gross said.
The other case involved a bite on the ankle from a copperhead, which the child's parents brought with them.
But the snake didn't inject very much venom, and the youngster was sent home after an extended period of observation.
Two snakebite cases in one night was a rare occurrence. In fact, those were the only two Gross has seen this year.
Georgia and South Carolina are home to at least 40 species of snakes. Most are harmless and, for the most part, beneficial to the environment.
In the Augusta area, however, three of the region's six venomous species can be commonly found:
- The copperhead is a shy creature that prefers wet, wooded areas and high places in swamps. Copperheads are light brown with saddle-shaped crossbands and blend easily into dry leaves and foliage.
- The cottonmouth, or water moccasin, typically grows to 3 or 4 feet but can be unusually thick. These stand their ground when disturbed and will wander far from water in search of food. They resemble the common water snake.
- The canebrake rattler, also called timber rattler, is one of the area's largest snakes, often reaching 6 feet. It is passive unless disturbed and easily identified by its rattles.
Encounters with venomous snakes rarely result in bites, said Dr. Whit Gibbons, a University of Georgia herpetologist and professor emeritus.
When they do, it is usually because someone tried to handle the creature, said Gibbons, who has captured and studied thousands of snakes in his 50-year career.
"More than half the snakebites to people in the U.S. are to people who pick the snake up," he said. "The best thing, if you don't know exactly what you're doing, is just don't pick it up."
Cottonmouths, for example, are cowards first, preferring to stay hidden and undetected. They rarely bite.
"Their venom is to get food, to kill prey," Gibbons said. "They don't want to waste it on something they can't eat."
Gibbons once studied "cottonmouth aggression" by tampering with the reptiles in ways you should never try: nudging and kicking them, stepping on them and eventually picking them up.
"We tested 48 different cottonmouths," he said. "When you just stand beside them, they open their mouths. They do it because they're scared."
Then the snakes emit a foul odor -- a measure designed to discourage predators.
Next came physical contact.
"After 20 seconds, we nudged them," Gibbons said. "And after that we stepped on them, right into the middle of their back, and pinned them for 20 seconds more."
None of the snakes bit when stood close to or nudged, and, of the 30 cottonmouths stepped on, only one actually bit.
The final test involved picking the snakes up. Gibbons built a prosthetic arm, complete with flannel shirt sleeve, wristwatch and a gloved hand.
"Of the 30 we picked up, 40 percent of them bit the hand," Gibbons said.
Rattlesnake bites are also rare and occur most often in situations where someone tried to handle or molest them, he said.
Copperheads, however, are a little different.
"First, they are small and camouflaged, and people just don't see them," Gibbons said. "Second, cottonmouths might be abundant in a swamp, but copperheads turn up almost everywhere."
Copperheads also give little warning, he said.
"A rattlesnake rattles, and a cottonmouth opens up its mouth and jaws as a threat display," Gibbons said. "A copperhead might just strike."
Copperheads, he added, inject less venom than the two larger species.
"They are more common but less dangerous," he said. "Almost no one gets killed from a copperhead bite, but you can certainly die from rattlesnakes and cottonmouths."
There are dozens of nonvenomous snakes in the area, many of which are hacked to pieces by gardeners, shot or run over by people who don't know any better.
A black rat snake, one of the largest local snakes, can consume as many as 78 rats a year. Killing them increases the rodent population, which increases the destruction of nesting birds and other creatures.
The Eastern kingsnake is another especially good neighbor, Gibbons said.
"They are immune to the venom of rattlesnakes, cottonmouths and copperheads, and they'll actually eat them," he said
The harmless water snake is often the victim of its resemblance to the venomous water moccasin.
A study along the Savannah River several years ago showed water snakes outnumbered cottonmouths 100-to-1.
"There are lots of species of water snakes in this area: brown, green, southern banded, northern, red-bellied and some smaller ones too," Gibbons said.
The ones most often killed after being mistaken for cottonmouths are the red-bellied and the banded.
"When the females get larger they can look almost black, very much like a cottonmouth," he said. "They can even spread their head out so it appears arrowhead-shaped."
Bites from nonvenomous snakes result in many visits to emergency rooms and physicians' offices.
"A large percentage of our calls from come from health care facilities," said Jessica Wehrman, the communications manager for the American Association of Poison Control Centers. "It is not unusual, or rare, for a doctor treating someone to call and ask for help locating antivenin."
During 2008, the most recent year with complete national figures available, the association reported 3,192 poisonous bites, which were divided among copperheads (1,268), rattlesnakes (1,130), cottonmouths (185), coral snakes (98) and unknown native pit vipers (511).
The association reported 2,950 bites from nonvenomous or unknown species. Among the total (6,142 bite cases), two resulted in fatalities.