Rotational thromboelastometry guided transfusion in venom-induced consumptive coagulopathy following a haemotoxic snakebite.
Miriyala Gaayathri, Amrithanand Vt, Manjupriya G et al.
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Case in brief
A woman in her 30s presented with severe haemotoxic snake envenoming and venom-induced consumptive coagulopathy (VICC), leading to early multiorgan involvement. Despite initial treatment, her coagulopathy persisted, with conventional tests showing only mild abnormalities. Rotational thromboelastometry (ROTEM) revealed severe hypocoagulability, and targeted transfusions based on ROTEM findings successfully corrected her coagulation defects, resulting in clinical improvement.
What made this case unusual
The case illustrates the discrepancy between conventional coagulation tests and the severity of clinical symptoms in VICC, emphasizing the need for advanced diagnostic tools.
Diagnostic / clinical pearl
Clinicians should consider using ROTEM for a more accurate assessment of coagulopathy in cases of venom-induced consumptive coagulopathy, as conventional tests may underestimate the severity.
Why it matters
This case underscores the importance of advanced coagulation assessment techniques in managing severe snakebite envenomations, potentially improving patient outcomes.