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Defibrination and systemic bleeding caused by an imported African snakebite

Hantson, Philippea; Verhelst, Davida; Wittebole, Xaviera; El Gariani, Abdul Waheda; Goossens, Elisabethc; Hermans, Cédricb

European Journal of Emergency Medicine: December 2003 - Volume 10 - Issue 4 - p 349-352
CASE REPORT
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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.

aDepartment of Emergency Medicine and Intensive Care

bLaboratory of Hemostasis, Cliniques St-Luc, Université Catholique de Louvain, Brussels, Belgium

cPoisons Control Center, Brussels, Belgium

Correspondence to Philippe Hantson, Department of Intensive Care, Cliniques Universitaires St-Luc, Avenue Hippocrate 10, 1200 Bruxelles, Belgium

Tel: +32 2 7642743; fax: +32 2 7648928;

e-mail: hantson@rean.ucl.ac.be

© 2003 Lippincott Williams & Wilkins, Inc.