Table 1.

Timeline of the case

April 6, 2018

20:00 hours: The patient is bitten in his right foot by an adult specimen of Bothrops asper

April 7, 2018

08:00 hours: The patient is attended by a traditional healer who applies a plant-based poultice over the bitten area

April 8, 2018

The patient refers moderate edema in the bitten region and abdominal pain, dizziness, generalized weakness, and paresthesia in the bitten limb

April 9, 2018

15:00 hours: The patient is admitted to the Emergency Service of Hospital San Francisco, where clinical management starts. Physical examination and laboratory tests are carried out. Five vials of antivenom are administered

22:00 hours: Deterioration of the general condition is observed, together with a mild respiratory difficulty

April 10, 2018

10:50 hours: On physical examination, the patient shows decreased vesicular breath sounds and dullness on percussion

12:00 hours: X-ray analysis is carried out with the patient in the upright position, revealing pleural effusion in the left lung. A thoracic tube (Pleur-evac) is placed

13:00 hours: 1,350 mL of a serosanguineous fluid is collected

April 11, 2018–April 12, 2018

An additional volume of 250 mL is drained by Pleur-evac. Two units of packed red blood cells are transfused because of the blood loss

April 13, 2018

The general condition of the patient improves, and the pleural effusion has been resolved

April 14, 2018

The thoracic tube and the Pleur-evac system are removed

April 19, 2018

The general condition of the patient is good and he is discharged