Thromboelastrography in Boomslang Envenomation (Dispholidus typus)

A 33 years male presented with haemotoxic envenomation after being bitten by a boomslang (Dispholidus typus). The boomslang bite induces venom induced consumptive coagulopathy in which factors II, IX and X is activated. A procoagulant state is induced which may be evident within four hours but may be delayed by 72 hours.

Mr. M, presented with severe life threatening coagulopathy, his management and clinical improvement is demonstrated using thromboelastography in the form of ROTEM®. The case report demonstrates ROTEM findings after boomslang envenomation as well as the response to antivenom treatment. We highlight the importance of thromboelastography compared to traditional coagulation tests. We also reflect on the use of plasma derived blood products in the treatment of coagulopathy induced envenomation as opposed to antivenom therapy in correcting the coagulopathy.