{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T06:06:53Z","timestamp":1785564413835,"version":"3.56.0"},"reference-count":13,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,2]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>We report the case of an 11-year-old boy brought to our emergency department 2\u2009hours after a viper bite to his right hand. He suffered severe pain and rapidly progressive swelling with signs of haemodynamic compromise in keeping with distributive shock. The oedema progressed from his right wrist upwards to his forearm and upper arm with compartment syndrome ultimately resulting. He underwent fasciotomy of the right upper limb and antivenom serum was given. The patient required vasopressors for 48 hours and a total of nine surgical interventions were necessary. In the event of a snakebite, it is essential to promptly recognise the signs of severity, complications and indications for the administration of antivenom serum. We intend to highlight this rare shock aetiology and the need for emergency management if severe clinical signs are present. Early administration of antivenom serum is essential and it should be available in all emergency departments.<\/jats:p>","DOI":"10.1136\/bcr-2020-240206","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T17:37:54Z","timestamp":1612892274000},"page":"e240206","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["When snakebites complicate: a paediatric case with shock and compartment syndrome"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6561-2153","authenticated-orcid":false,"given":"Joana","family":"Carvalho","sequence":"first","affiliation":[{"name":"Pediatric Department, Unidade Local de Saude de Matosinhos EPE, Senhora da Hora, Portugal"},{"name":"Pediatric Intensive Care Unit, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediatrico de Coimbra, Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Moinho","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediatrico de Coimbra, Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Macao","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Service, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pedi\u00e1trico de Coimbra, Coimbra, Coimbra, Portugal"},{"name":"University Clinic of Pediatrics, Universidade de Coimbra Faculdade de Medicina, Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiomar","family":"Oliveira","sequence":"additional","affiliation":[{"name":"University Clinic of Pediatrics, Universidade de Coimbra Faculdade de Medicina, Coimbra, Coimbra, Portugal"},{"name":"Child Developmental Center, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pedi\u00e1trico de Coimbra, Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"2025082802065876000_14.2.e240206.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31224-8"},{"key":"2025082802065876000_14.2.e240206.2","first-page":"515","article-title":"Snake-bites\u202f: appraisal of the global situation","volume":"76","author":"Chippaux","year":"1998","journal-title":"Bull World Heal Organ"},{"key":"2025082802065876000_14.2.e240206.3","doi-asserted-by":"crossref","first-page":"17063","DOI":"10.1038\/nrdp.2017.63","article-title":"Snakebite envenoming","volume":"3","author":"Guti\u00e9rrez","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"2025082802065876000_14.2.e240206.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002162"},{"key":"2025082802065876000_14.2.e240206.5","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.arcped.2011.08.030","article-title":"[Pediatric adder bites]","volume":"18","author":"Claudet","year":"2011","journal-title":"Arch Pediatr"},{"key":"2025082802065876000_14.2.e240206.6","doi-asserted-by":"publisher","DOI":"10.1542\/pir.20-5-147"},{"key":"2025082802065876000_14.2.e240206.7","first-page":"125","article-title":"Mordedura de v\u00edbora, situa\u00e7\u00e3o RaRA MAS potencialmente Grave","volume":"43","author":"Carvalho","year":"2012","journal-title":"Acta Pedi\u00e1trica Port"},{"key":"2025082802065876000_14.2.e240206.8","first-page":"148","article-title":"Mordedura de v\u00edbora \u2013 situa\u00e7\u00e3o potencialmente Grave","volume":"12","author":"Marta","year":"2005","journal-title":"Med Interna"},{"key":"2025082802065876000_14.2.e240206.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra013477"},{"key":"2025082802065876000_14.2.e240206.10","doi-asserted-by":"crossref","first-page":"618","DOI":"10.4414\/smw.2005.11198","article-title":"Viper bites: treat or ignore?","volume":"135","author":"Petite","year":"2005","journal-title":"Swiss Med Wkly"},{"key":"2025082802065876000_14.2.e240206.11","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3390\/toxins1020100","article-title":"Asp viper (Vipera aspis) envenomation: experience of the Marseille poison centre from 1996 to 2008","volume":"1","author":"de Haro","year":"2009","journal-title":"Toxins"},{"key":"2025082802065876000_14.2.e240206.12","unstructured":"World Health Organization . 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