• Abhay Kant, Mingwei Ng, Ming Jing Elizabeth Tan, and Assoc Prof Ponampalam R.
• Accident & Emergency Department, Changi General Hospital, Singapore; Sing Health Cluster Toxicology Service, Singapore. Electronic address: dr.abhaykant2007@gmail.com.
• Am J Emerg Med. 2024 Oct 1; 84: 190.e1190.e5190.e1-190.e5.

AbstractAs the landscape becomes more urbanized, snakebites have increasingly become uncommon presentations to the emergency departments in Singapore, while snakebites causing significant envenomation are even rarer. In this case report, we discuss a 55-year-old man who had significant envenomation from a Shore Pit Viper (Trimeresurus Purpureomaculatus) and who was successfully treated with haemato-toxic polyvalent antivenom (HPAV). He initially presented with pain, swelling and bleeding over his wound. Due to a deterioration in his coagulation profile, he was given two doses of HPAV which is typically reserved for viperid snakes instead. Following administration of the anti-venom, the patient's coagulation profile improved, and the local soft tissue effects of the venom resolved. He did not manifest any adverse effects and was discharged uneventfully about 72 h after the snakebite. The cross-neutralization potential of HPAV for Shore Pit Viper (Trimeresurus Purpureomaculatus) venom in this case study suggests that there may be a possible common underlying chemical structure and pathophysiology among the venom proteins of various snake species. Given that Trimeresurus-specific antivenom is unavailable in most countries, this cross-neutralization strategy deserves further consideration and evaluation in similar circumstances.Copyright © 2024 Elsevier Inc. All rights reserved.

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