The above symptoms can manifest within 5 hours after envenomation. Pain and edema usually begins within the first few minutes after the bite. The symptoms can be divided into four categories. Edema, pain, and blister formation around the bite site. Though pain and edema are the major local manifestations, hemorrhage around the bite site and local blister formation is common.
Tissue necrosis is seen less frequently.
Local and scattered discoloration of skin can also manifest. Generally Lachesis venom consumes prothrombin and fibrinogen. This results in a DIC type coagulopathy with an increase in coagulation and bleeding times. Fibrinogen levels and sedimentation rates are generally decreased. White blood cell counts may elevate and hematocrit decrease, but cell morphology is usually within normal limits.