Exotic snake bite: a challenge for the Scandinavian anesthesiologist?

Venomous snake bites are uncommon in the Scandinavian countries. Envenomation from exotic snakes do however occur, mostly amongst snake handlers. This case report documents the effects and treatment for envenomation from Hoplocephalus bungaroides, or the Broad-Headed snake, native to eastern and southern Australia. Snakes of the genus Hoplocephalus have previously been described as of 'lesser medical importance' because of their rarity.

This case report describes the signs, symptoms and management of systemic envenomation in a previously healthy man.

The patient developed signs of severe coagulopathy less than an hour after envenomation. There was also biochemical evidence of rhabdomyolysis, and cardiotoxicity. At no time did the patient develop respiratory insufficiency, neurotoxicity or renal failure. The patient was initially managed with i.v. crystalloids, plasma, corticosteroids and antifibrinolytics and by observation in the intensive care unit (ICU). Coagulopathy resolved after causal treatment with monovalent Tiger snake antivenom.

The patient made good progress and was well on discharge from the ICU 26 h postenvenomation.