Acute kidney injury secondary to Eastern Brown snake (Pseudonaja textilis) bite: a case study

In Australia each year there are approximately 3000 incidents of snake bite, resulting in 1 to 4 deaths. Of Australian snakebite fatalities, 60% are caused by brown snake envenomation. The most common effect brown snake venom has on the human body is venom-induced consumptive coagulopathy, which can lead to secondary conditions such as haemorrhage, microangiopathic haemolytic anaemia and acute kidney injury. The venom can also cause neurotoxicity, systemic symptoms, collapse and cardiac arrest. The purpose of this case study is to describe and investigate the acute kidney injury that occurred as a consequence of a bite from an Eastern Brown snake. The patient developed anuric acute kidney injury secondary to microangiopathic haemolytic anaemia and required haemodialysis (HD) for three weeks. This case study will describe the clinical events in detail, discuss the pathophysiology underlying the venom-induced consumptive coagulopathy and acute kidney injury that developed, and also reflect on the treatment of the patient including HD, antivenom and first aid. It is intended that this case study will contribute to the limited amount of evidence currently available, and help build the knowledge and preparedness of health professionals for similar situations.