Atypical Presentation of Envenomation

Snake bite, bee, and wasp stings are common medical emergencies presenting to our hospitals in India. Usually, presentation of snake bite includes descending paralysis in the form of ptosis, dysphagia, and blurring of vision, in the form of cellulitis or bleeding from the site of bite. Cerebrovascular accident, angle-closure glaucoma, and brachial artery thrombosis are some of the rare complications of this medical emergency. A 32-year-old female and 48-year-old male presented with cerebrovascular accident as the initial complaints to the hospital. A 50-year-old male presented with blurring of vision and history of snake, which was later diagnosed to be angle-closure glaucoma. A 70-year-old male presented with cerebrovascular accident as well as thrombosis of brachial artery with history of multiple bee stings. Diagnosis was confirmed with radiological investigations and ophthalmic examination. Early treatment with antisnake venom was initiated in all four patients. All patients recovered with treatment and were discharged. Early identification of the complication and early initiation of treatment plays a key role in preventing mortality and morbidity.