Brown snake envenomation complicating near drowning and amphetamine overdose

A case is described of a near drowning and amphetamine overdose in a patient who developed rapidly progressive coagulopathy, thrombocytopaenia and anuria. As the coagulation abnormality was not perceived to be in keeping with the amphetamine toxicity, a septic and toxological screen were performed which revealed a positive urine result for Pseudonaja texilis envenomation. Despite resuscitation using coagulation factors and monovalent antivenom, the patient died. This case highlights the importance of early testing for envenomation when an atypical coagulopathy is present.