The puffadder ( Bitis arietans) is the most common, highly venomous snake in Sub-Saharan Africa. The World Health Organization (WHO) predicted that the number of snakebite victims is likely to increase in the future because of climate warming and globalization. Snakebite injuries are common life-threatening emergencies for the inhabitants of tropical Asia and Africa, mostly those involved in outdoor activities. Further studies are needed to prove the safety and efficacy of rTM administration and HBO therapy as an adjunct or alternative therapy with antiserum for fatal snakebite. ![]() The patient recovered without complications after the multidisciplinary treatment. In addition, hyperbaric oxygen (HBO) treatment was also performed to reduce local swelling. We initiated fluid resuscitation and administered recombinant thrombomodulin (rTM) to prevent venom-induced consumption coagulopathy. The swelling spread rapidly to the upper arm and there was a risk of bleeding, suggesting the need for antivenom administration, but this could not be acquired because of lack of stock. A 23-year-old man was bitten on his left hand by a puff adder that he illegally kept in his house. We report a case of a puff adder ( Bitis arietans) bite treated without antivenom. However, antivenoms may not be available in instances where non-native vipers are kept in captivity. Antivenoms are the treatment of choice for managing lethal snakebites.
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