To share another experience of a life-threatening medical emergency: An 18-year-old healthy adult was brought to the A&E department of a medical college hospital after being bitten by a large viper (the victim's relatives brought the killed snake with them). He had signs of envenoming including prolonged coagulation time. As he was started on snake anti-venom he developed severe anaphylaxis that necessitated multiple doses of adrenaline, steroids and antihistamine to desensitise him.
The worried postgraduate trainee was reluctant to give further doses of anti-venom after the first vial of polyvalent anti-venom that resulted in severe anaphylaxis. How will you manage this young man with viper-bite envenoming and severe allergy to anti-venom?
