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- Title
SEA SNAKE BITE COMPLICATED WITH RHABDOMYOLYSIS, ACUTE RENAL FAILURE AND COMPARTMENT SYNDROME: A SUCCESS STORY.
- Authors
C. H., Nor Aizal; M., Sukeri; A., Fazlina
- Abstract
Introduction: Sea snake venoms are more toxic than those of land snakes. However, cases of sea-snake bites with systemic envenomation are rare. Sea snake venoms are myotoxic, leading to generalized rhabdomyolysis. Effective treatment of sea snake poisoning required specific antivenom. Supportive therapy is also crucial in the overall management. Case Report: We reported a case of a sea-snake bite with systemic envenomation. A 27 year-old Cambodian man was bitten by a sea snake over his right foot while fishing. He developed rhabdomyolysis and associated acute renal failure as the complication from the myotoxins. He also developed respiratory embarrassment due to the neurotoxins. He was given 17 vials of sea snake antivenom. He had vigorous fluid replacement with forced mannitol-alkaline diuresis for ongoing rhabdomyolysis. He also had CVVH therapy followed by haemodialysis. However, later he also developed bilateral upper limb compartment syndrome as a result of on-going rhabdomyolysis and underwent fasciotomy and carpal tunnel release. He had prolonged ventilation complicated with nosocomial chest infection and was extubated after 34 days. He developed critical illness polyneuropathy, however muscle power improved with physiotherapy. His renal function recovered fully and haemodialisis was stopped after 6 weeks. He was discharged well after 77 days of admission. Discussion & Conclusions: We reported a successful treatment of a rare case of sea snake bite with systemic envenomation. The patient developed acute renal failure and compartment syndrome due to ongoing rhabdomyolysis. 17 vials of sea snake antivenom, fasciotomy and intensive supportive therapy were given.
- Subjects
SEA snakes; SNAKEBITES; ANTIVENINS; ACUTE kidney failure; COMPARTMENT syndrome; RHABDOMYOLYSIS
- Publication
Malaysian Journal of Medical Sciences, 2008, p180
- ISSN
1394-195X
- Publication type
Article