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Case Report: Anaphylactoid Shock Associated with Snakebite Envenoming in Portugal

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  • 1 Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto, Porto, Portugal;
  • | 2 Serviço de Doenças Infeciosas, Centro Hospitalar Universitário do Porto, Porto, Portugal;
  • | 3 Serviço de Cuidados Intensivos, Centro Hospitalar Universitário do Porto, Porto, Portugal

ABSTRACT.

Although rare in Portugal, snakebite envenoming entails severe morbidity and mortality. We present the case of a 65-year-old woman bitten on her leg in a northern coastal region in Portugal, on a walk during the COVID-19 pandemic lockdown. Despite first looking for help at the nearest pharmacy, she developed anaphylactoid shock and was promptly driven to a tertiary hospital, where antivenom was administered in a timely manner under close monitoring. Prophylactic antibiotics were started and maintained based on elevated inflammatory markers and signs of wound inflammation. She evolved favorably, with rapid weaning of vasopressors and resolution of end-organ dysfunction. This case highlights the importance of prompt recognition and describes crucial steps in envenomation management in a country where snakebite is infrequent, but potentially fatal.

Author Notes

Address correspondence to António Lamas, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal. E-mail: antonio.lamas@chporto.min-saude.pt

These authors contributed equally to this work.

Authors’ addresses: António Lamas and Marli Ferreira, Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto, Porto, Portugal, E-mails: antonio.lamas@chporto.min-saude.pt and marliferreira1992@gmail.com. Joana Fragoso and Ana Cipriano, Serviço de Doenças Infeciosas, Centro Hospitalar Universitário do Porto, Porto, Portugal, E-mails: joana.teixeirafragoso@gmail.com and acipriano88@gmail.com. Rute Alves, Serviço de Cuidados Intensivos, Centro Hospitalar Universitário do Porto, Porto, Portugal, E-mail: ruteifalves@gmail.com.

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