Bleeding Wisdom tooth following snakebite: a case report

Parsley snake (Echis carinatus) venom is a complex mixture of toxins. This venom contains metalloproteinases which convert prothrombin to meizothrombin. The prothrombin activator leads to the formation of small blood clots inside the blood vessels throughout the body. The case of a 24-year-old man living in the of Zabol city (Sistan and Baluchistan province) who was bitten by a snake on the right ankle (inner malleolus). This patient was brought to the emergency room at 24 o'clock with bleeding only from the decayed upper right wisdom tooth. patient immediately received 6 vials of anti-venom, but still the bleeding does not stop. Urgent CBCdiff, PT, PTT, INR tests were requested. The initial test was normal. 6 hours later, the test shows that the platelet level has decreased (from 200.000 to 120.000). Hydrocortisone ampoule 200μm, 6 more vials of anti-venom are received and finally the bleeding stopped and the platelets also increased (170.000). At the time of discharge, tetanus and tetabulin ampoules were injected. The snakebite treatment protocol should be done cautiously and carefully, because any negligence may lead to dangerous complications for the patient. Public education provided by health centers is essential to prevent snakebite.