Challenges of managing viper envenomation

Abstract

The signs and symptoms following snakebite envenomation vary according to the type of snake encountered. Typically, Viperidae (vipers) envenomates with a hemotoxin causing coagulopathy and muscle breakdown, while elapids envenomate with a neurotoxin. However, these are not exclusive; the venom from elapids can have a hemotoxic effect and that of the Viperidae can be neurotoxic. We present a case series of viper envenomation presenting to the emergency department at a secondary care Indian Navy Hospital during 2019–2020. These cases highlight the clinical challenges involved in presentation of viper envenomation.

Keywords

• acute kidney injury
• acute respiratory distress syndrome
• antisnake venom
• disseminated intravascular coagulation
• twenty-minute whole blood clotting time