A snake bite case: The value of timely diagnosis and treatment

Abstract

Introduction: Venomous snake bites can produce different symptoms. Missing a diagnosis of a toxic snake bite by a medical practitioner will lead to a delay in the specific antivenin administration, hence an unfavorable outcome. Case presentation: A 29 years old housewife came to the Emergency Department of the Mansoura University Hospital complaining of a swelling in her right arm after an exposure to an unknown bite at her house yard. Initial examination revealed a fully conscious patient with stable vital signs and arterial blood gases. Local examination of the patient's right arm showed edema, redness, hotness, swelling, tenderness and two insertion sites in her right arm with dark tissues around. Diagnosis of a vasculo-toxic snake bite was made, and snake antivenin was promptly administered in the intensive care unit (ICU). Immediate management of any complication was done, e.g. the shock, the impaired kidney functions, lungs infection, and the gangrenous area over the bitten limb. The patient survived and was discharged, with a follow up plan of the gangrenous limb with a plastic surgeon, and complete healing of the affected limb occurred without any residual disability or disfigurement. Conclusion: A snake bite should be suspected in patients presented with a history of bite and a local swelling with local signs of inflammation, even if the biting animal has not been seen. General examination and careful monitoring is important for assessment of patients and consulting different specialties according to the clinical picture of the patient is necessary to reach a favorable outcome.