A 60-year-old male with bloody diarrhea and altered mental status secondary to a suspected intravascular crotalid envenomation.
We present the case of a 60-year-old male who presented to our emergency department approximately 2 hours after a suspected intravascular pit viper envenomation to the area of the left ankle. By his arrival to our facility he was profoundly confused and hypotensive with bloody diarrhea, coagulopathy and multi-organ dysfunction including renal insufficiency, non-ST elevation myocardial infarction, lactic acidosis and hemoconcentration. His only cutaneous sign of envenomation was a small (1-2 cm) area of ecchymosis adjacent to the Achilles tendon on the lateral aspect of the ankle. He was given aggressive crystalloid resuscitation for circulatory support and received 20 vials of Cro-fab (10 vials 2 hours apart) and 2 units of FFP in the Emergency Department. The patient ultimately had resolution of his coagulopathy and was discharged on hospital day five with no long term sequela.
Oklahoma School of Community Medicine, Department of Emergency Medicine, USA.
B
B
Burns
W
W
Banner
E
E
Roper
D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D003221:Confusion / Q000209:etiology*; D003967:Diarrhea / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D012909:Snake Bites / Q000150:complications* / Q000188:drug therapy*; D017819:Viperidae
D000997:Antivenins