Late onset of bilateral cerebral infarction following Russell’s viper (&lt;em&gt;Daboia russelii&lt;/em&gt;) bite

Rmmkn Rathnayaka,Pean Ranathunga

doi:10.4038/slja.v25i1.8165

Abstract

Correction: On 8th February 2017, the authors of this paper were changed from RMMK Rathnayaka and PEA Ranathunga TO RMMKN Rathnayaka and PEAN Ranathunga. The title of the paper was also amended from ' Daboia russelli ' TO ' Daboia russelii '. A 53yr old male patient presented with a history of Russell’s viper bite to his right side leg. He developed acute kidney injury (AKI) and respiratory failure and intubated and given ICU care. On day 21 of snake bite he was found to have left side weakness of body and revealed bilateral cerebral infarction in CT brain. However the patient died 26th day of snake bite due to complications of acute ischemic stroke and AKI. This is one of rare complications of snake bite and the late onset of cerebral infarction following Russell’s viper bite which was not previously documented.

Highlights

Russell’s vipers (Daboia russelii) are widely distributed in all climatic zones in Sri Lanka
We describe one of the rare complications, bilateral ischaemic cerebral infarction following Russell’s viper bite in a previously healthy man
Case report A 53 year old previously healthy married male patient, a manual labourer was transferred to General Hospital, Ratnapura from a local hospital with reduced urine output following a snake bite to the right side of his leg 18hrs before admission (Figure 1)

Summary

Introduction

Russell’s vipers (Daboia russelii) are widely distributed in all climatic zones (wet, dry, intermediate and arid) in Sri Lanka. Typical neurological manifestations are ptosis, external ophthalmoplegia and respiratory failure.[1,2,3,4] Atypical presentations are hemiparesis, coma, lowering in Glasgow Coma Scale (GCS), convulsions, expressive dysphasia[1,5] and blindness.[6] We describe one of the rare complications, bilateral ischaemic cerebral infarction following Russell’s viper bite in a previously healthy man. Case report A 53 year old previously healthy married male patient, a manual labourer was transferred to General Hospital, Ratnapura from a local hospital with reduced urine output following a snake bite to the right side of his leg 18hrs before admission (Figure 1).

Results

Conclusion