The Compartment Syndrome Associated with Deep Vein Thrombosis due to Rattlesnake Bite: A Case Report

Abstract

Background: Snakebite is a health issue specific to someparts of the world, especially in the tropical areas, whereit produces many victims. The main clinical damagecaused by snakebite involves haemotoxic, neurotoxicand myotoxic reactions. We report the case of a youngwoman suffering from snakebite who developed deepvein thrombosis and compartment syndrome.Case Report: We present the case of a 32-yearoldRomanian woman who was injured by her ownCrotalinae snake (also known as pit viper or rattlesnake)on her left forearm. When admitted to our EmergencyDepartment, she was conscious with a Glasgow comascale of 12/15, somnolent, febrile, suffering of headache,tachypnoea; the marks of the snakebite were located inthe distal part of the anterior left forearm; she had painand bleeding at the bite site and swelling of the left upperlimb with lymphangitis up to the axilla. She experiencedfasciotomy-requiring compartment syndrome of theupper limb and required unfractionated heparin andclose monitoring using activated partial thromboplastintime evolution due to micro-thrombosis in the brachialvein. Local improvement was achieved in the next 4days with progressive diminishment of local tendernessand swelling.Conclusion: Limb deep vein thrombosis might beinduced by snakebite, despite the pro-haemorrhagicgeneral condition induced by the envenomation. A highindex of clinical suspicion is needed for early diagnosisand timely management, which can improve survival ofthese patients.