ABSTRACT
Introduction: We report the unusual presentation and complications of a case of snakebite, involving a child and his mother, who were bitten by the same snake. Clinical Picture: The mother was well but the child developed worsening local pain and swelling. Treatment and Outcome: Test doses of antivenom were administered but he developed anaphylactic shock. Subsequently, he developed compartment syndrome and fasciotomies were performed. Conclusions: This report serves to alert the public to a few of the avoidable risk factors associated with snakebites (such as avoiding areas known to harbour snakes in the evening in summer and autumn, and wearing protective footwear), and the clinician of the important management issues in snake-bites. Precautions for anaphylaxis must be taken when antivenom is administered. If a bitten patient with rapid extension of local injury does not receive any antivenom, compartment syndrome complicating local injury can occur.
Snakebites have become uncommon in the metropolitan and densely populated city of Hong Kong.1-3 We recently reported a 10-year survey of snakebites in children in Hong Kong and concluded that children should be discouraged to play in areas where snakes may hide and that protective footwear should be worn.4 We now report the unusual presentation and complications of a case of snakebite, involving a child and his mother, who were bitten by the same snake. The subsequent evolution of local injury, occurrence of anaphylaxis to antivenom, and development of compartment syndrome are documented and various management issues discussed.
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