Non cardiogenic pulmonary edema in a case of viperidine snake bite

Abstract

Background: Anaphylaxis reactions are common during the use ofASV. We are reporting a case of ASV induced pulmonary edema in a 23 years old male with history of viperine snake bite. Case Report: A 23 years old ill looking male presented with swelling and pain left lower limb, was febrile with tachycardia, respiratory rate of 24/minute, Blood Pressure of 90/60 mm Hg and 02 saturation of 96% at room air. Local examination of revealed two puncture marks with edema andpetechiae. His bedside 20 min whole blood clotting test (WBCT) was deranged. The patient was given 10 vials of anti snake venom and after 90 mins of ASV administration, the patient became restless, with a temp of 104°F, pulse rate of 144/min, BP of140/70, RR of 38/min and Sp02 of 74% at room air with bilateral coarse crackles over all lung fields. Urgent chest x-ray suggested pulmonary edema. He responded well to symptomatic management. Discussion: Up to 80% of patients treated with antivenoms present with adverse effects like anaphylactoid or pyrogenic reactions, or late serum sickness4. In our case, the pulmonary edema was not due to the snake bite neither was it due to fluid overload. Pulmonary edema developed 90 mins after ASV administration. Conclusion: Direct causation of pulmonary edema due to ASV should be kept in mind while managing snake bite cases.

Keywords

• Pulmonary edema
• Viperidine Snake Bite
• Antisnake venom