Venom with an altitude: Coagulopathy following an envenomation by the high-mountain snake Gloydius monticola (Likiang pitviper) in Yunnan Province, China.
Zichen Qiao, Yong Tang, Chen Liu et al.
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Case in brief
A 34-year-old male experienced a severe envenomation after being bitten by a Likiang pitviper (Gloydius monticola) at an elevation of 3500 m. Initial symptoms included local pain and swelling, which progressed to severe coagulopathy with hypofibrinogenemia and prolonged clotting times. While early treatment with Gloydius brevicaudus antivenom did not halt the coagulopathy, subsequent administration of Deinagkistrodon acutus antivenom appeared to facilitate recovery.
What made this case unusual
This case is notable as it documents the first human envenomation by Gloydius monticola, revealing its potential to cause life-threatening coagulopathy.
Diagnostic / clinical pearl
Clinicians should be aware that envenomation by Gloydius monticola can lead to severe coagulopathy, necessitating careful monitoring and management.
Why it matters
The differential response to different antivenoms emphasizes the importance of understanding venom characteristics and evaluating antivenom efficacy for lesser-known pitviper species.