Prolonged defibrination syndrome after green pit viper bite with persisting venom activity in patient's blood

Abstract

Venom activity in citrated plasma from a patient with a green pit viper bite was demonstrated by measuring its ability to decrease fibrinogen levels in normal plasma for six days after the bite. By in-vitro study, the minimal amount of crude venom to induce hypofibrinogenemia was 0.5 μg/ml of normal plasma. The findings explained the continuing defibrination with bleeding and especially the failure of fresh-frozen plasma transfusion to correct hypofibrinogenemia in this patient. The most beneficial therapy should therefore be the neutralization of venom by antivenine, for as long as abnormal coagulation profiles are present, to discontinue the defibrinating process. The preparation of potent antivenine must be encouraged.