The Gaboon viper (Bitis gabonica) is an exotic snake native to sub-Saharan Africa. Gaboon viper
venom is an extremely toxic
hemotoxin, causing severe coagulopathy and local tissue
necrosis. These are not aggressive snakes and therefore
bites involving humans are rare and there is not a substantial amount of literature documenting how to manage these
injuries and resultant coagulopathies. We report a 29-year-old male presenting 3 hours after a Gaboon viper envenomation resulting in coagulopathy requiring massive
resuscitation and multiple doses of
antivenom. The patient received various blood products based on thromboelastography (TEG) and also underwent early
continuous renal replacement therapy (CRRT) to assist in correction of severe
acidosis and
acute renal failure. The combination of TEG to guide
resuscitation, administration of
antivenom, and early implementation of CRRT allowed our team to correct
venom-induced consumptive coagulopathy and ultimately allow the patient to survive following this extremely deadly Gaboon viper envenomation.