Abstract
We describe rare envenomation by an eastern green mamba (Dendroaspis angusticeps). A 40-years-old man was bitten by an eastern green mamba that he had kept illegally and brought to the emergency room within 30 minutes of the bite. We confirmed severe pain, swelling and continuous bleeding from his left index finger. We did not administer antivenom considering the risk of anaphylaxis and the time required to obtain it. We simply washed the wound and observed the patient. Swelling spread to the trunk within 3 days and blood blisters formed on his left forearm. A coagulation disturbance that seemed to be caused by the snake venom spontaneously improved within 6 days. The blood blisters were all epithelialized within 13 days. The patient was discharged on hospital day 44. The focal puncture site was deeply ulcerated and required 136 days to epithelialize. Mamba venom reportedly contains neurotoxins that cause paralysis and death due to respiratory failure, but disordered blood coagulation is rare. Accumulated case reports will help to understand mamba envenomation.
