Clinical characteristics and outcomes of Malabar Pit Viper envenomation from North Kerala

Abstract Snake bite is an important public health problem in all the tropical countries, and especially in India. Malabar pit viper, being endemic to western ghats of India, is responsible for many snake bites in this region. We conducted a retrospective study on Malabar pit viper bites between January 2021 and December 2022 at our tertiary care center in Wayanad. We identified 20 confirmed cases of Malabar pit viper envenomation and data pertaining to bite site, fang marks, local reaction, basic laboratory reports, 20-minute whole blood clotting time (WBCT), administration of Anti-Snake Venom (ASV), dose of ASV, reactions, duration of hospital stay, and outcomes of patients was ascertained. Bites were in the upper limb in 14 (70%) of the 20 patients. The 20-minute WBCT was prolonged in 8 (40%) out of 20 patients. Among the 20 cases, 15 (75%) received one or more doses of ASV. All patients recovered without any residual effects with two patients (10%) developing complications due to cellulitis and ASV allergic reaction respectively. Development of species specific antivenom and awareness about clinical profile and outcomes of MPV envenomation will help to rationalize use of the expensive and scarce polyvalent ASV in India.