TRIMERESURUS TRUONGSONENSIS BITE: A CASE REPORT FROM VIETNAM

Abstract

Trimeresurus truongsonensis is a species of venomous snake belonging to the viper family.  In this study we report a case of a T. truongsonensis bite.  The study subject is a 20-year-old male who was mountain climbing in Quang Binh Province, Vietnam when he found, caught and brought home a T. truongsonensis viper to keep as a pet.  He was feeding the snake on 9 January 2025 when he was bitten on the back of his right hand by the snake.  Two hours and forty-five minutes later he presented to Bach Mai Hospital Poison Control Center with pain and swelling at the bite site.  He was admitted to hospital and liver and kidney function tests, electrolyte levels, CK (creatine kinase) level and highly sensitive troponin T tests were performed and all the results came back normal but on a complete blood count the white blood cell count was elevated (13.46 g/l), as was the percent neutrophils (81.27%) and the fibrinogen level was low (1.58 g/l; normal range: 2-4 g/l).  The fibrinogen level continued to decrease until it reached a nadir at 10 hours post snake bite (1.44 g/l) and then gradually increased to normal (2.07 g/l) 34 hours post snake bite.  The patient was supported with intravenous fluids; he was given a dose of anti-tetanus serum, and given prophylactic clindamycin intravenously at a dose of 1,800 mg/day.  The patient was not given antivenin.  He was discharged home 48 hours post snake bite with no pain and normal blood tests.  We review the clinical management of this type of snake below.