[Suppurative coxitis after a viper bite--case report]

A 46-year-old woman having sustained a rhinoceros viper bite to the left lower leg is presented. She was treated at Department of Infectious Diseases, Split University Hospital. After 20 days she left the hospital in good condition, with a small crust at the bite site. About ten days later suppurative secretion developed at the bite site and a few days later she felt pain in her right hip and leg, and turned febrile. She was treated at home with antibiotics and analgetics for nearly one month. Her condition was worsening, and she was referred to Department of Neurosurgery, for suspected lumboischialgia. Then, she was transferred to the Department of Orthopedics as suspected septic coxitis, where she was operated on. The disease was not recognized on time, appropriate treatment was introduced too late, and irreparable consequences developed in the right hip. To the best of our knowledge, this is the first reported case of coxitis, especially on the contralateral side to the snake bite. Infection from the site of snake bite on the left lower leg could have been transferred to the right hip exclusively by hematogenous way. Our objective is to warn of this rare snake bite complication, and to contribute to better diagnostic and therapeutic management in similar situations.