Table 4.
Clinical details of patients with delayed adverse reactions associated with the administration of antivenom.
| Characteristics | Patient No. | ||
|---|---|---|---|
| 1 | 2 | 3 | |
| Age (years)/Sex | 41/Female | 89/Female | 51/Male |
| Comorbidities | None | HTN, DM | DM |
| Snake species | Gloydius brevicaudus | Unknown | Unknown |
| Bite site | Foot | Foot | Foot |
| Grade classification | III | III | III |
| Symptoms | Foot pain | Foot pain | Foot pain |
| Antivenom administration | |||
| Location | ED | ED | ED |
| Pretreatment | None | None | None |
| Infusion rate (units/min) | 20 | 50 | 16 |
| Dose (units) | 6000 | 6000 | 6000 |
| Adverse reactions after antivenom | |||
| Onset (hours) | 240 | 48 | 37 |
| Symptoms | Skin rash | Fever | Fever |
| Vital signs after adverse reactions | |||
| SBP/DBP (mmHg) | 100/60 | 110/60 | 130/90 |
| HR (beats/min) | 70 | 80 | 80 |
| RR (breaths/min) | 18 | 20 | 20 |
| BT (°C) | 37.2 | 38.0 | 38.1 |
| Blood oxygen saturation (%) | 100 | 100 | 100 |
| Mental status | Alert | Alert | Alert |
| Treatment for adverse reactions | Antihistamines, corticosteroids, topical steroids |
Antipyretics | Antipyretics |
| Additional antivenom | Yes | Yes | No |
| Dose (units) | 12,000 | 6000 | |
| Location | Ward | Ward | |
HTN = hypertension; DM = diabetes mellitus; ED = emergency department; SBP = systolic blood pressure; DBP = diastolic blood pressure; HR = heart rate; RR = respiratory rate; BT = body temperature.