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Progression of a snakebite case in Sri Lanka
Courtesy of Dr. Kolitha Sellahewa, MBBS, MD

54 year old woman bitten at 8.45pm, admitted to TH Karapitiya at 9.45 pm. Snake brought to hospital, identified as Russell,s viper. A 20 min. Whole Blood Clotting Test was conducted and proved positive- the blood did not clot. Ptosis and a swollen leg were noted as the symptoms.

Russell's Viper killed after snakebite

The available antivenom was given, a dose of 20 vials. Coagulopathy (lack of blood clotting) persisted and the antivenom therapy was repeated twice. The patient became drowsy and dyspnoeic (breathing with difficulty) on day 2 where she was transferred to ICU and ventilated. The patient developed DIC, which leads to the formation of small blood clots inside the blood vessels throughout the body. As the small clots consume coagulation proteins and platelets, normal coagulation is disrupted and abnormal bleeding occurs. Acute renal failure ensued and the patient died on day 3.

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