When snakebites complicate: a paediatric case with shock and compartment syndrome

BMJ Case Rep. 2021 Feb 9;14(2):e240206. doi: 10.1136/bcr-2020-240206.

Abstract

We report the case of an 11-year-old boy brought to our emergency department 2 hours after a viper bite to his right hand. He suffered severe pain and rapidly progressive swelling with signs of haemodynamic compromise in keeping with distributive shock. The oedema progressed from his right wrist upwards to his forearm and upper arm with compartment syndrome ultimately resulting. He underwent fasciotomy of the right upper limb and antivenom serum was given. The patient required vasopressors for 48 hours and a total of nine surgical interventions were necessary. In the event of a snakebite, it is essential to promptly recognise the signs of severity, complications and indications for the administration of antivenom serum. We intend to highlight this rare shock aetiology and the need for emergency management if severe clinical signs are present. Early administration of antivenom serum is essential and it should be available in all emergency departments.

Keywords: emergency medicine; neonatal and paediatric intensive care; paediatrics.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Antivenins / therapeutic use
  • Child
  • Compartment Syndromes / etiology*
  • Compartment Syndromes / surgery*
  • Hand Injuries / etiology*
  • Hand Injuries / surgery*
  • Humans
  • Male
  • Shock / drug therapy*
  • Shock / etiology*
  • Snake Bites / complications*
  • Snake Bites / drug therapy
  • Viper Venoms / toxicity
  • Viperidae

Substances

  • Antivenins
  • Viper Venoms