GRAVECOMPLICOUSOPHIDAL ENVENTION OF A
ARACHNOIDAL HEMORRHAGIA

A. BELHADJ***, K .HAJJI***, H. KBIRI***, N.ZAMRAOUI**, R. SEDDIKI*
Page No. 1-11

Introduction: Ophidian envenomation is a global public health problem. In Morocco, she was
responsible for 72 deaths, the cause of which is usually haematological, neurological, respiratory,
renal or haemodynamic failure. Observation: We report the case of severe envenomation secondary
to a viper bite in a 37 year old patient who required early ventilatory management because of the
occurrence of a state of convulsion. The initial assessment reveals a clinical and biological
hemorrhagic syndrome with a state of deep defibrination. He was responsible for moderate
arachnoid hemorrhage. FAV Afrique® immunotherapy combined with symptomatic resuscitation
were effective, and the haemostasis assessment normalized before the 24th hour (TP, TCA and
platelets) and later for fibrinogenemia (3rd day). The patient leaves the intensive care unit at day 9
and the hospital at day 14 with follow-up in neurology consultation. Conclusion: Snakebites are
medico-surgical emergencies of concern, responsible for high mortality in Africa. In Morocco, and
even if these figures are relatively low, they can not be reassuring. In the absence of specific
immunotherapy, it is lawful to attempt treatment with FAV Afrique® in order to take advantage of
the paraspecificity (although disputed) of the antivenoms pending the availability of an antivenom
adapted to local species.
Keywords : Ophidian envenomation, Echisarietans, subarachnoid haemorrhage, specific
immunotherapy.