Russell's viper envenomation: The challenge of diagnosis

Russell's viper envenomation is rare in Taiwan, and its typical clinical presentations, including consumption coagulopathy, acute renal failure, haemolysis, and increased capillary permeability, have been reported in the literature as case reports or series. Here, we report a case with an atypical presentation, and suspected to be a Russell's viper bite due to the distinct distribution characteristics of the snake and some progressive clinical signs/symptoms. He returned to health successfully after the correct antivenom was administered, and envenomation was ultimately confirmed by venom detection in the patient's serum and urine samples.