When snakebites complicate: a paediatric case with shock and compartment syndrome

Area of Science:

• Toxicology
• Emergency Medicine
• Clinical Case Study

Background:

• Viper envenomation can lead to severe systemic and local effects.
• Distributive shock is a rare but critical complication of snakebites.
• Compartment syndrome requires urgent surgical intervention.

Observation:

• An 11-year-old boy presented with a viper bite to the hand, rapidly developing severe pain, edema, and hemodynamic compromise consistent with distributive shock.
• The edema progressed proximally, leading to compartment syndrome in the right upper limb.
• The patient required vasopressors for 48 hours and nine surgical procedures, including fasciotomy.

Findings:

• Early administration of antivenom serum is critical in managing severe viper envenomation.
• Prompt recognition of shock and compartment syndrome is essential for timely intervention.
• Fasciotomy and vasopressor support were necessary components of the management.

Implications:

• This case highlights distributive shock as a rare etiology following viper bites.
• Highlights the importance of readily available antivenom serum in emergency departments for snakebite management.
• Emphasizes the need for prompt emergency management protocols for severe clinical signs of snakebite envenomation.