Boomslang (Dispholidus typus) bite. A case report and a review of diagnosis and management

Very few cases of boomslang (Dispholidus typus) envenomation have been described. A case report is presented, illustrating many pitfalls in diagnosis and treatment. Despite a fully established clinical picture of diffuse intravascular clotting (DIC), response to specific boomsland antivenom was immediate, even as late as 86 hours after the bite. Some of the literature regarding the snake, the clinico-pathological effects of the venom, and treatment is reviewed and discussed. Administration of specific antivenom is the only curative measure, while administration of fresh blood and plasma appears to be the most useful supportive measure. Other measures, including the controversial use of heparin and corticosteroids, are discussed. Reactions to the antivenom, both early and late, are discussed, and methods of prevention and control of reactions are suggested.