title: Defibrination and systemic bleeding caused by an imported African snakebite.
abstract: A 55-year-old man was referred from Burkina Fasso for coagulation disorders with severe spontaneous systemic bleeding. He had been bitten six days before by a snake that could not be definitely identified. No specific treatment had been started in Africa. The patient was admitted with severe anaemia, incoagulable blood with undetectable fibrinogen. Multiple haematomas in the chest and abdomen were found at computed tomography. Blood transfusions and the administration of fresh frozen plasma and fibrinogen did not result in any clinical or biological improvement. The clinical course was dramatically reversed after the infusion of two vials of Pasteur polyspecific antivenom (Echis-Bitis-Naja). According to the geographical distribution of this snake species, it seems very likely that the snakebite was caused by Echis ocellatus. Even given with delay, the antivenom was effective and well tolerated.
authors.affiliation: Department of Emergency Medicine and Intensive Care, Université Catholique de Louvain, Brussels, Belgium. hantson@rean.ucl.ac.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Hantson
authors.forename: David
authors.initials: D
authors.lastname: Verhelst
authors.forename: Xavier
authors.initials: X
authors.lastname: Wittebole
authors.forename: Abdul Wahed
authors.initials: AW
authors.lastname: El Gariani
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Goossens
authors.forename: Cédric
authors.initials: C
authors.lastname: Hermans
mesh_terms: D000997:Antivenins / Q000627:therapeutic use; D002050:Burkina Faso; D004338:Drug Combinations; D004635:Emergency Medicine / Q000379:methods*; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012909:Snake Bites / Q000150:complications*; D014195:Travel; D016896:Treatment Outcome; D014757:Viper Venoms / Q000009:adverse effects*
chemical_list: D000997:Antivenins; D004338:Drug Combinations; D014757:Viper Venoms