_IMMEDIATE:_ Very little pain, if any
_LOCAL:_
1. 2-8 Hours—Mild to severe pain with redness and vesiculation at bite
site, followed by ischemia
2. 3-4 Days—Star-shaped firm area of deep-purple color with necrosis
3. 7-14 Days—Central area of depression and ulceration
4. 21 Days—Healing and scar formation. May not heal sufficiently and
may require skin grafting
_SYSTEMIC:_
1. Fever, chills, nausea, vomiting, weakness, joint pain
2. Morbilliform or petechial generalized eruption
3. Occasionally serious hematological disturbances—hemolytic anemia,
thrombocytopenia
_DEATHS:_ Reported; usually in children, due to renal failure and
hematological abnormalities.