Abstract/Summary

Snakebite envenoming and its resulting complications are serious threats to the health of vulnera-ble people living in rural areas of developing countries. The knowledge of the heterogeneity of symptoms associated with snakebite envenoming and their management strategies is vital to treat such life-threatening complications to save lives. Russell’s viper envenomation induces a di-verse range of clinical manifestations from commonly recognised haemotoxic and local effects to several rare conditions that are often not reported. The lack of awareness about these unusual manifestations can affect prompt diagnosis, appropriate therapeutic approaches, and positive outcomes for patients. Here, we report pulmonary thromboembolism that developed in three pa-tients following Russell's viper envenomation and demonstrate their common clinical features and diagnostic and therapeutic approaches used. All patients showed clinical signs of local (oe-dema) and systemic (blood coagulation disturbances) envenomation, which were treated using polyvalent antivenom. They exhibited elevated heart rates, which is a non-specific but core pa-rameter in the diagnosis of pulmonary embolism. The recognition of pulmonary embolism was also achieved by an electrocardiogram, which showed sinus tachycardia and computed tomog-raphy and echocardiogram scans further confirmed this condition. Anti-coagulant treatment us-ing low molecular weight heparin offered clinical benefits in these patients. In summary, this re-port reinforces the broad spectrum of previously unreported consequences of Russell’s viper en-venomation. The constant updating of healthcare professionals and the dissemination of major lessons learned in the clinical management of snakebite envenoming through scientific documen-tation and educational programs are necessary to mitigate the adverse impacts of venomous snakebites in vulnerable communities.