Epinephrine Leukocytosis, swelling and tachycardia: case reportA 47-year-old man developed leukocytosis, swelling and tachycardia following misuse of epinephrine [dosage & route not stated]. The man presented to the emergency department (ED) for alleged snake bite on both forearms. An examination showed leukocytosis, tachycardia and swelling on the right forearm. Radiographs revealed soft tissue swelling on the right forearm. Based on his past information of repeated ED visits and hospital admissions for alleged snake bites; he was kept under observation. His symptoms didn't progress. He was discharged with primary care referral instruction [outcomes not stated]. He had misused epinephrine autoinjectors for simulating symptoms of snake bite.Author comment: "His misuse of epinephrine autoinjectors mimicked symptoms of envenomation."Abdelmalek D, et al. Factitious snake envenomation and narcotic-seeking behavior.