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Hypertensive encephalopathy following snake bite in a child: A diagnostic dilemma

Syed Moied Ahmed1, Mozaffar Khan, Zeeba Zaka-Ur-Rab

  • 1Department of Anaesthesiology, J N Medical College, Aligarh Muslim University, Uttar Pradesh, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|August 29, 2013
PubMed

Insights

Snake bites in rural Indian children can present atypically. Prompt anti-snake venom treatment is crucial for neurotoxic envenomation, even without classic symptoms, improving patient outcomes.

Area of Science:

  • Pediatrics
  • Toxicology
  • Emergency Medicine

Background:

  • Snake bites pose a significant health risk to children in rural India.
  • Delayed diagnosis and treatment are common due to atypical presentations and incomplete medical histories.

Observation:

  • An 8-year-old boy presented with convulsions, unconsciousness, and severe hypertension.
  • Initial management for hypertensive encephalopathy yielded no improvement over 20 hours.
  • Review of history suggested a neurotoxic snake bite, despite the absence of typical local signs.

Findings:

  • Administration of anti-snake venom led to a rapid and complete recovery.
  • This case highlights the importance of considering snake envenomation in undiagnosed neurological emergencies.

Implications:

  • Clinicians should suspect snake bite in rural children presenting with neurological symptoms like convulsions and unconsciousness, particularly with hypertension.
  • Even in the absence of local swelling or pain, neurotoxic snake envenomation should be considered in the differential diagnosis.
  • Early and appropriate administration of anti-snake venom can be life-saving in these challenging cases.

Keywords:
Hypertensionpediatricsnake bite

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