A CASE OF SNAKE BITE WITH UNUSUAL COMPLICATIONS AND REVIEW OF LITERATURE

Snakebites, including poisonous ones, are common occurrence in tropical countries and endemic during summer months. However, snake bite remains a neglected public health problem resource limited like India. The venom may cause local cytotoxicity, hemotoxicity, neurotoxicity myotoxicity. Cardiac involvement is not usually encountered has been extensively discussed. It however reflected ECG changes, echocardiographic raised cardiac enzymes new unexplained events.We recently managed case of cobra envenomation who presented with features cytotoxicity leading to extensive cellulitis, coagulopathy neuroparalysis. He was polyvalent anti-snake (ASV) administration supportive treatment. recovered from neuroparalysis successfully weaned off the ventilator. Three days later, he developed ischemic cerebral infarction left ventricular failure (LVF). Electrocardiography showed fresh ST-T changes anterior inferior leads. Echocardiography revealed severe, (LV) dysfunction, markedly reduced ejection fraction (LVEF 20-25%) mid-basal apical akinesia. patients LVF diuretic resolved over next 48 h. Repeat echo after three marked improvement LVEF 50% only mild hypokinesia akinetic segments. transient findings were suggestive diagnosis stress (Takotsubo) cardiomyopathy. We report this for its unusual complications review relevant literature.