Snakebite in a child: could we avoid the anaphylaxis or the fasciotomies?

INTRODUCTION We report the unusual presentation and complications of a case of snakebite, involving a child and his mother, who were bitten by the same snake. CLINICAL PICTURE The mother was well but the child developed worsening local pain and swelling. TREATMENT AND OUTCOME Test doses of antivenom were administered but he developed anaphylactic shock. Subsequently, he developed compartment syndrome and fasciotomies were performed. CONCLUSIONS This report serves to alert the public to a few of the avoidable risk factors associated with snakebites (such as avoiding areas known to harbour snakes in the evening in summer and autumn, and wearing protective footwear), and the clinician of the important management issues in snakebites. Precautions for anaphylaxis must be taken when antivenom is administered. If a bitten patient with rapid extension of local injury does not receive any antivenom, compartment syndrome complicating local injury can occur.