A case of acute renal and respiratory failure due to mamushi bite

Abstract

Mamushi is recognized as one of the most hazardous vipers, and in Japan, more than 1,000 people are bitten by mamushi every year; approximately 10 patients die because of its venom. We report a case of mamushi bite complicated with acute renal and respiratory failure. A 72-year-old man had a mamushi bite on his left palm. The patient was conservatively treated by his family doctor for 12 hr, after which progressive swelling of the left upper limb and myoglobinuria prompted the doctor to refer him to our hospital. In spite of the administration of mamushi antivenin and cepharanthine, hemodialysis, continuous hemodiafiltration and mechanical ventilation were required for acute renal and respiratory failure. The patient left our hospital after 46 days of intensive care. Although the most common complication of mamushi bite is acute renal failure, recent reports have suggested that mamushi venom by itself causes lung toxicity. Acute lung injury and acute renal failure should be carefully monitored during the treatment of mamushi bite.