A case report of Ovophis monitcola (Mountain pit-viper) envenoming in northeastern India resulting in prolonged coagulopathy.

ABSTRACT

India is home to a diverse spectrum of medically-significant snakes accounting for one of the world's largest burdens of envenoming, morbidity and mortality. Indian polyspecific antivenom is derived from the venom of four snake species (Daboia russelii, Echis carinatus, Naja naja and Bungarus caeruleus), considered to be responsible for the majority of snakebite morbidity and mortality in India. The treatment of envenoming from other less-commonly encountered venomous snake species can be challenging. In this report, we describe the case of a 32-year-old male who presented with local swelling and coagulopathy following a bite from Ovophis monitcola (mountain pit-viper) in Nagaland, Northeast India. Local and systemic envenoming, failed to respond to Indian polyspecific antivenom and venom-induced consumption coagulopathy, confirmed by bedside and laboratory-based clotting assays, persisted for more than three weeks. Remote consultation with a national-level Poison Control Centre helped establish the responsible snake species and guide appropriate medical management.