Delayed neurological manifestation in viper bite despite anti-snake venom therapy

Abstract

Envenomation due to snake bite is an acute life threatening medical emergency. Among the different families of snakes, viper bites are known to cause local manifestations like cellulitis, blebs, compartment syndrome; as well as systemic manifestations which include neurological, hematological and renal failure. This is a case of a middle aged man who presented with viper bite. He was given anti-snake venom (ASV) and became asymptomatic. After about 72 hours of ASV therapy, he started developing generalised paralysis. He was given another course of ASV, following which he recovered completely. To the best of knowledge, this form of delayed neurological manifestations following viper bite, despite receiving ASV has not been reported yet.