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Snakebite in a child: could we avoid the anaphylaxis or the fasciotomies?
K L E Hon1, C M Chow, K L Cheung
1Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong. ehon@cuhk.edu.hk
Insights
A child experienced severe anaphylactic shock and compartment syndrome after a snakebite, despite antivenom. This case highlights critical snakebite management issues and anaphylaxis precautions.
Area of Science:
- Toxicology
- Emergency Medicine
- Clinical Case Reports
Background:
- Reports an unusual snakebite case involving a mother and child bitten by the same snake.
- Highlights the importance of understanding diverse snakebite presentations.
Observation:
- The child presented with severe local pain and swelling post-snakebite.
- The mother remained asymptomatic, indicating differential envenomation severity.
Findings:
- Child developed anaphylactic shock following antivenom administration.
- Compartment syndrome complicated the local injury, necessitating fasciotomies.
Implications:
- Underscores the need for anaphylaxis precautions during antivenom therapy.
- Emphasizes prompt management of local snakebite injuries to prevent complications like compartment syndrome.
- Advises public awareness of snakebite risk factors and preventative measures.
Introduction:
We report the unusual presentation and complications of a case of snakebite, involving a child and his mother, who were bitten by the same snake.
Clinical Picture:
The mother was well but the child developed worsening local pain and swelling.
Treatment And Outcome:
Test doses of antivenom were administered but he developed anaphylactic shock. Subsequently, he developed compartment syndrome and fasciotomies were performed.
Conclusions:
This report serves to alert the public to a few of the avoidable risk factors associated with snakebites (such as avoiding areas known to harbour snakes in the evening in summer and autumn, and wearing protective footwear), and the clinician of the important management issues in snakebites. Precautions for anaphylaxis must be taken when antivenom is administered. If a bitten patient with rapid extension of local injury does not receive any antivenom, compartment syndrome complicating local injury can occur.
