Treatment with snake antivenom of a patient presenting with diplopia resulting from a snake bite (Gloydius blomhoffii) 30 hours before : A case report

Abstract

An 89-year-old woman checked herself into our emergency room presenting with diplopia after a snake bite one day before on the third finger of her left hand by Gloydius blomhoffii (mamushi). We treated her with snake antivenom 30 hours after the snake bite. The treatment improved her double vision, and she was discharged after 4 hospital days. Mamushi venom contains a hemorrhagic toxin and a small amount of neurotoxin that induces extraocular muscle impairment. Her double vision indicated the large dose and reflected the severity of the venom intoxication and considering this she was treated with antivenom therapy for the diplopia. We should treat patients with severe symptoms of snake venom with antivenin therapy as soon as possible. However, it is sometimes difficult to identify the snake bite as that of a mamushi. That is why the victims of venomous snakes delay in seeking medical attention. Antivenom can be administered safely by preparing for an anaphylaxis reaction or serum disease.