Bilateral blindness following Russell’s viper bite - a rare clinical presentation: a case report

Subasinghe, Chandrika Jayakanthi; Sarathchandra, Chamara; Kandeepan, Thambyaiah; Kulatunga, Aruna

doi:10.1186/1752-1947-8-99

Cited by 20 publications

(15 citation statements)

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“…32 C J Subasinghe et al report the case of a Sri Lankan lady who presented with bilateral blindness secondary to a bilateral posterior circulation ischemic stroke instead of the usual neurological manifestations of Russell's viper envenomation. 33 Kumar et al has reported on a case of exudative retinal detachment following snake bite, the mechanism of which is still un explained.…”

Section: Discussionmentioning

confidence: 99%

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

George¹,

Asha²,

Ravindran³

et al. 2017

Int J Res Med Sci

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Background: Snake bite is a neglected public health problem worldwide especially in the tropics. Studies on ocular manifestations are still fragmentary. The objective of the study was to find ocular manifestations among the snake bite cases with systemic envenomation admitted in the intensive care units in a tertiary care hospital in rural North Kerala, India during a period of 4 years from May 2012 to May 2016.Methods: It was a prospective, observational, cross sectional study. Institutional ethical committee approval was obtained for the study. A descriptive analysis of snake bite cases with systemic envenomation was done. Other snake bites are excluded from the study. Patients who needed ophthalmological opinion for ocular symptoms were analyzed.Results: Total suspected snake bites admitted in ICUs during the study period were 638. Only 7 patients (1%) with haematotoxic envenomation needed ophthalmological opinion for ocular symptoms. Patients in the present study ranged between the age of 11 and 53. Ocular lesions diagnosed among the 6 patients who developed capillary leak syndrome, were bilateral angle closure glaucoma in 3 patients, pan uveitis, disc edema and retinal haemorrhages in 2 patients, bilateral macular oedema. Youngest patient had intracranial haemorrhage and bilateral orbital hemorrhage, leading to exposure keratitis. SAV was administered in all patients ranging from 11-30 vials. All the patients except the patient with orbital haemorrhage had a grave prognosis. Still only one of these patients expired on day 3, rest all patients had better vision and survived due to timely management.Conclusions: A timely intervention especially at the initial presentation of capillary leak syndrome, can decrease the morbidity and save the life of a patient.

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Section: Discussionmentioning

confidence: 99%

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

George¹,

Asha²,

Ravindran³

et al. 2017

Int J Res Med Sci

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“…8 Bilateral blindness due to ischaemic infarcts involving occipital lobes following a D.russelii was documented too. 6 Cerebral infarctions are due to thrombotic occlusion of medium to large vessels in brain and this is due to the prothrombotic properties of Russell's viper venom. 5,6,7,8,9,10,11 In our patient left sided hemiparesis was found on day 21 following snake bite due to bilateral cerebral infarction.…”

Section: Case Reportmentioning

confidence: 99%

“…6 Cerebral infarctions are due to thrombotic occlusion of medium to large vessels in brain and this is due to the prothrombotic properties of Russell's viper venom. 5,6,7,8,9,10,11 In our patient left sided hemiparesis was found on day 21 following snake bite due to bilateral cerebral infarction. This was a late onset of infarction compared to previous reported cases which was documented as minutes to 4 days after the snake bite.…”

Section: Case Reportmentioning

confidence: 99%

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Late onset of bilateral cerebral infarction following Russell’s viper (<em>Daboia russelii</em>) bite

Rathnayaka¹,

Ranathunga²

2017

Sri Lankan J Anaesthesiol

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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.

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“… 2 Local cellulitis, renal failure, and systemic hemorrhage are the common clinical manifestations of a viper bite. 2 Neurological sequelae due to cerebral infarction are rare, 3 and there are few reports of posterior circulation ischemic infarction. 4 , 5 Indian tree viper ( Trimeresurus gramineus ) is a venomous pit viper species found only in southern India.…”

mentioning

confidence: 99%

A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite

et al. 2014

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Bilateral blindness following Russell’s viper bite - a rare clinical presentation: a case report

Cited by 20 publications

References 10 publications

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

Late onset of bilateral cerebral infarction following Russell’s viper (<em>Daboia russelii</em>) bite

A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite

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