Multiple thromboembolic strokes in a toddler associated with Australian Eastern Brown snake envenomation

Abstract

Venomous snakes are found in every state and territory in Australia and are amongst the most dangerous in the world. Of Australia's snakes the Eastern Brown snake ( Pseudonaja textilis ) is responsible for the majority of the cases of envenomation and death. We describe a case of thromboembolic stroke associated with Eastern Brown snake envenomation in a 2-year-old boy. Following the incident, the boy has made a good recovery.

Children and Snakebite: Snake Venom Effects on Adult and Paediatric Plasma

“…Furthermore, being physically smaller is likely to increase the severity of the medical emergency from snakebite envenomation due to relatively higher venom concentrations, i.e., a lower dilution effect in children during envenomation. These relatively high venom concentrations are evident in: thromboembolic strokes in a 2-year-old toddler bitten by Pseudonaja textilis (Eastern Brown Snake) [ 19 ]; the compartmental syndrome observed as a common complication in over half of envenomed paediatric patients in Costa Rica [ 20 ]; more severe cytotoxicity in children than adults from South Africa [ 21 , 22 ]; higher rates of necrosis, ecchymycosis, and pulmonary edema in children in Turkey [ 23 ]; several forms of rattlesnake-induced coagulation disturbances being more common in paediatric patients than adult patients [ 24 ]; and particularly poor outcomes in patients ≤5 years [ 25 ].…”