gms | German Medical Science

Objectives/Interrogation: A bite from the King Cobra is often fatal due to its potent venom. This case report describes a man who survived a king cobra bite to his index finger and the subsequent disease process and management of snake envenomation.

Methods: The patient's case notes were reviewed and details regarding admission and treatment was recorded. A literature review of snake bites and envenomation by king cobras was performed to inform the case recommendations.

Results and Conclusions: A 32 year old professional snake carer working in a zoo sustained a king cobra bite to his index finger when trialling a snake handling glove he had invented. He was acutely admitted to an intensive care unit. His finger progressively swelled around his puncture wound with development of finger compartment syndrome and the entire digit became necrotic over the course of a few days. He was manged with serial debridement and ultimately required an amputation of the finger, however he did survive the potentially fatal envenomation.

In this rare case we discuss the management principles of snake bites and envenomation, the physiological and pathological properties of snake venom, the indication for antivenom and the potentially digit saving procedure of early compartment release and finger fasciotomy.

Conclusion: Prompt management is essential in rare venomous snake bites including antivenom and early washout and decompression of compartments at risk. These early interventions have the potential to be digit, limb and lifesaving.