Abstract
A 7-year-old boy was bitten by Mamushi and he presented swelling and pain on his right upper arm. He was brought to our hospital about ten hours after surgical treatment performed by a family doctor. The severity of the snakebite was Grade III. The intracutaneous reaction test against the anti toxin was negative, and methylprednisolone was administered for the prevention of possible allergic reaction to antivenom. Anaphylaxis symptoms such as rash, wheezing and shortness of breath appeared immediately after administration of antivenom. Administration of intramuscular 0.1% adrenaline and intravenous hydrocortisone improved the symptoms immediately. Since the antivenom derives from the serum of horses, it has been described that it frequently induces anaphylaxis. However, most cases of anaphylaxis were those of adults, with few reports of pediatric patients. Although some cases of snakebite in childhood in Japan have been described, no pediatric cases of anaphylaxis to antivenom have not been reported. Further studies are needed to define the indication of prophylaxis use of adrenaline as that in abroad.
