A Tropical Kiss by a Malabar Pit Viper

Area of Science:

• Herpetology
• Toxicology
• Emergency Medicine

Background:

• Snakebite envenomation in India is primarily associated with the
• big 4
• species, for which polyvalent anti-snake venom (ASV) is the standard treatment.
• However, the envenomation burden from other venomous snakes, such as
• Trimeresurus malabaricus
• , is significant but less recognized.

Observation:

• This case report details a facial bite inflicted by a
• Trimeresurus malabaricus
• (Malabar pit viper) on a tree climber in India's Western Ghats.
• The envenomation resulted in severe local effects, including facial edema, and systemic manifestations such as coagulopathy and hypotension.

Findings:

• Diagnostic tools, including thromboelastogram, infrared thermography, and routine laboratory tests, were employed to assess the envenomation severity.
• The patient received Indian-made polyvalent anti-snake venom, which was effective in managing the envenomation.

Implications:

• This case underscores the importance of recognizing and treating envenomation by less commonly known venomous snakes like
• Trimeresurus malabaricus
• .
• Polyvalent ASV demonstrated efficacy in treating severe envenomation from this species.
• Early diagnosis and appropriate ASV administration are crucial for favorable patient outcomes in snakebite incidents.