a b s t r a c tCompartment syndrome, once diagnosed is almost always followed by a decision of fasciotomy, here we present a case of compartment syndrome which turned out to be secondary to a snakebite and where prophylactic fasciotomy is not considered in such a case as discussed in literature.Ó 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Case reportA 1-year old Omani child, with no known comorbidities, presented with 1 day history of swelling of the left lower limb. He was referred to the A&E from the Orthopaedics OPD.The previous afternoon, the patient was with his family at the Jabal, in an area full of grass around 1 foot high, around a spring. According to the mother, the patient was walking on his own on a pavement situated between grasses when he suddenly fell on both his knees. The patient didn't cry and the mother said she spotted few drops of blood oozing from the left knee only, then after half an hour she noticed the swelling. The mother said the child didn't cry during the whole event, and afterward he slept for 2 h, then he woke up crying and the swelling has increased and extended involving the whole thigh. The mother said when he woke up, the thigh was hot and he had fever (not documented). The family took him to a local health center, where by that time, it was still limited to the thigh and it was only a mild swelling according to the mother, there his temperature was noted to be high (mother doesn't recall how high) and he was given antibiotics.In the evening he started to vomit, he had 6 episodes of vomiting, which was yellowish in color, non-projectile, so he was taken to the A&E and an X-ray was taken of the limb, as the mother initially gave a history of fall from a height.They were referred then to the Orthopaedics OPD the following day and presented with an extended swelling of the left lower limb, and tense calf muscles, with pain on passive extension and was diagnosed to have compartment syndrome, so was sent immediately to the A&E. The mother denied doing any massage to the limb, and besides the given antibiotics, she applied turmeric on the whole limb.Upon arrival in the A&E the patient was in distress, being tachycardic of around 150 bpm reaching 180 bpm, was sick looking, in pain. Local examination of the left lower limb showed extensive swelling of the left lower limb compared to the right. Swelling was extending from his left groin to the ankle, involving the scrotum.The limb was covered by turmeric (herbal treatment) so was yellowish in color. There was significant tenderness on palpation and the left calf muscles were quite tense. There was increased pain on passive dorsiflexion.Distal pulses: dorsalis pedis and posterior tibial artery were palpable bilateral capillary refill time at the left toes were 3e4 s.Patient was initially planned for urgent fasciotomy because of the clinical findings, but upon investigations it was found he was having deranged coagulation p...