Abbreviation: N/A = not available
On the first day of hospitalization, with the possibility of viral
infection, was prescribed Acyclovir tablet 400 mg Tds, and for bacterial
infection, Ceftriaxone vial 1 gr Bd , Teicoplanin (Targocid) 400 mg Bd
and Meropenem 1 gr Bd intravenous infusion and as well as with
probability of snakebite, 5 vials of antivenom via intravenous infusion
,then 6 hours after the first injection, received 5 vials of antivenom
and also 2 vials of antivenom every 6 hours in three times as a
maintenance dose along with the medications he was already taking. The
left upper limb was elevated and a hot water bag was used to reduce
stiffness and edema in blister-free areas.
As for the increase in BUN and creatinine in the patient’s blood sample,
nephrology consultation was requested. Also following receiving
antivenom, decrease in BUN and Creatinine levels and normalization of
the level of consciousness, the diagnosis of acute interstitial
nephritis (AIN) following snake bite was proposed.
On the second day, the Teicoplanin (Targocid) antibiotic was
discontinued and Ciprofloxacin 200 mg IV infusion was replaced. The
wound was drained and then Eude Alibore solution, Silver Sulfadiazine,
and Zinc Oxide ointments were also used for topical treatment of
blisters.
The patient was monitored in the poisoning ward for 3 weeks, after which
the fever, hematoma, and skin lesions resolved; the radial pulse is
fully and symmetrical in the involved limb. Also, serum levels of BUN,
Creatinine, PT, PTT, and INR returned to normal range and the patient
was discharged from the hospital by good general condition (figure 1-C,
D). The patient gave verbally informed consent in this regard.