Keywords
anti-venomous sero-therapy
Mali
poison control
How to Cite
Abstract
We report the case of a 69-year-old man who consulted the emergency department of a French peripheral hospital after seven days of a viper bite in Mali. He had received an anti-venomdose as well as oral metronidazole as antibiotic therapy during initial on-site treatment. He had a large swelling on the left arm with blisters and a wet necrosis appearance around the bite. Hemodynamic parameters were stable, the patient complained of paresthesias and intense pain. No significant biological inflammatory syndrome was found. Doppler ultrasound eliminated deep-vein thrombosis. The poison control center did not recommend a new sero-therapy. Treatment included intravenous antibiotic therapy and local healing in hospitalization with surgical debridement and hyperbaric sessions at the end.
Envenomation is a rare reason for admission to an emergency department in France. Four degrees of severity allow for initial non-prognostic classification. Our clinical case of grade 2 envenomation would provide an update on the emergency care at pre hospital and hospital levels. The viper venom contains components affecting hemostasis. The systemic action must be rapidly limited by anti-venomous serotherapy, preferably in a medical structure, rapidly distancing the prognosis and significantly reducing a pejorative evolution of scarring and function. Antibiotherapy is not routinely recommended, especially if the initial intrafocal wash and debridement measures are well performed. Simple preventive measures should be reminded to people who may be exposed in an occupational or leisure context.
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