# Severe Viper Envenomation: A Case Report From Portugal

**Authors:** Beatriz Vitó Madureira, Nuno Prucha Leite, David Costa, Rita Quelhas Costa

PMC · DOI: 10.7759/cureus.102157 · 2026-01-23

## TL;DR

A 57-year-old woman in Portugal suffered severe complications from a viper bite but fully recovered after timely antivenom treatment and supportive care.

## Contribution

This case highlights the critical need for early recognition and treatment of systemic viper envenomation in Portugal.

## Key findings

- Early antivenom administration and supportive care led to clinical and laboratory improvement.
- Persistent edema required a second dose of antivenom.
- The patient achieved full recovery following treatment.

## Abstract

Snakebite envenomation is uncommon in Portugal but may lead to significant morbidity when systemic toxicity develops. We report a case of a 57-year-old woman who presented with hypotension, progressive limb edema, and venom-induced coagulopathy following a viper bite. The progression of edema, together with systemic toxicity, prompted early antivenom administration and transfer to an intermediate care unit, with a second dose required in response to persistent edema. Supportive management included fluid resuscitation, limb elevation, and empirical antibiotic therapy for persistent fever. The patient showed progressive clinical and laboratory improvement, ultimately achieving full recovery.

This case underscores the importance of early recognition of systemic toxicity and timely antivenom therapy to prevent severe complications associated with viper envenomation.

## Linked entities

- **Diseases:** coagulopathy (MONDO:0001531)

## Full-text entities

- **Genes:** FGB (fibrinogen beta chain) [NCBI Gene 2244] {aka HEL-S-78p}
- **Diseases:** edema (MESH:D004487), Poison (MESH:D011041), viper bite (MESH:D001733), pain (MESH:D010146), inflammatory (MESH:D007249), hypofibrinogenemia (MESH:D000347), vomiting (MESH:D014839), fever (MESH:D005334), hypotension (MESH:D007022), nausea (MESH:D009325), hemorrhagic (MESH:D006470), Venom (MESH:D000092422), Snakebite envenomation (MESH:D012909), toxicity (MESH:D064420), thrombocytopenia (MESH:D013921), Envenomation (MESH:D065008), coagulopathy (MESH:D001778), infection (MESH:D007239), hematologic abnormalities (MESH:D006402), deaths (MESH:D003643), hemorrhagic blister (MESH:D001768), neurological or renal complications (MESH:D009422), cytotoxic tissue injury (MESH:D017695), erythema (MESH:D004890), necrosis (MESH:D009336), systemic toxicity (MESH:D010523)
- **Chemicals:** amoxicillin-clavulanate (MESH:D019980), clindamycin (MESH:D002981)
- **Species:** Vipera seoanei (species) [taxon 110211], Homo sapiens (human, species) [taxon 9606], Vipera berus berus (common viper, subspecies) [taxon 31156], Vipera latastei (species) [taxon 246179]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12925607/full.md

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Source: https://tomesphere.com/paper/PMC12925607