Medical management of a child treated for two unique envenomation episodes via captive snakes in a 60-day period: A case report

Abstract

Venomous snake bites can result in irreversible damage, leading to respiratory dysfunction, bleeding disorders, kidney damage, or serious complications. In recent years, with the popularity of online shopping in China, snakes can be easily purchased and kept as pets, even if some areas are not natural habitats for certain kinds of snakes. A 13-year-old boy purchased two venomous snakes online as pets. On April 16, 2019,the boy was bitten by a B. multicinctus(Bungarus multicinctus), and he had mild difficulty breathing and limb weakness. He was discharged after symptomatic treatment with B. multicinctus antivenom. On June 17, 2019, the boy was bitten a second time by a short-tailed pit viper (Gloydius brevicaudus) resulting in swelling and necrosis of the left hand. After a systemic and comprehensive treatment was implemented, including Agkistrodon halys antivenom injections, infection control, hormone therapy, improved circulation, negative pressure wound therapy, skin graft, and nutritional support, the boy recovered. This case provides valuable insights for diagnosing and treating venomous snake bites and their complications while also raising public awareness about the hazards of purchasing venomous snakes online,and it also provide case support for the improvement of online shopping for minors, wildlife protection, and live animal mailing management, helping to prevent such incidents from happening again.

Keywords: Antivenom; Bungarus multicinctus; Gloydius brevicaudus; Necrosis; Snake bite.

Fig. 1

A, a Bungarus multicinctus; B,a short-tailed pit vipers (Gloydius brevicaudus).

Fig. 2

A,The pit viper had bitten the boy on the left hand, which was visibly swollen and ecchymotic; B,local blackening and tissue necrosis.

Fig. 3

The boy underwent partial decompression and thorough debridement on his left hand.

Fig. 4

A,Postoperative VSD negative pressure suction was performed after the operation; B,The wound has healed well after the operation.