Mamushi bites in a kidney transplant recipient

Area of Science:

• Toxicology
• Nephrology
• Transplantation

Background:

• Mamushi (Gloydius blomhoffii) bites are Japan's most frequent venomous snakebites.
• Acute renal failure is a known, severe complication of mamushi envenomation.
• Clinical data on mamushi bites in kidney transplant recipients is scarce.

Observation:

• A 66-year-old kidney transplant recipient experienced a mamushi bite 3 years post-transplant.
• The patient's condition progressed similarly to typical mamushi bites, peaking on day 3.
• Aggressive fluid resuscitation and continuation of immunosuppressive therapy were administered.

Findings:

• The patient's clinical course mirrored that of non-transplant individuals with mamushi bites.
• No acute renal failure developed despite the envenomation.
• Standard management protocols, including supportive care and immunosuppression, were effective.

Implications:

• Kidney transplant recipients bitten by mamushi may follow a predictable clinical course.
• Continuing immunosuppressive drugs and providing adequate fluid infusion are crucial for managing these cases.
• This case suggests that mamushi bite management in kidney transplant recipients does not require significant deviation from standard protocols.