On the 28th November, a 26 year old man was sleeping after a heavy night with his friends. He went to bed at about midnight. He woke up because he was nauseous, went outside to vomit. Whilst heaving, he could feel something was wrong with his eye but was too drunk to take much notice. He went back to sleep. A while later, nausea woke him again. Once again he went outside to vomit. This time there was quite a lot of pain and he could feel a lot of swelling but went back to sleep. The third time he woke up, his mother heard him heaving and went to see what the matter was. She screamed when she saw his eye.
They knew a nurse who worked at a local clinic and went to wake her. She insisted that they go to the Good Shepherd hospital. He was admitted at 06:00 on the 29th November.
I was only contacted at approximately 16:00. I rushed to the hospital with antivenom. He received additional IV fluids (1L only) and pain medication. He seemed confused and uncomfortable and had difficulty responding to my questions. 10 vials of antivenom was administered IV push. There was a Pyrogenic reaction to the antivenom (3rd from the same batch of antivenom) but it was quite manageable.
The bite was obviously caused by a Mozambique spitting cobra.
Debridement took place after 5 days. Unfortunately I couldn’t make the procedure and do not have any pictures.
Skin graft after 12 days.
Although it is believed that antivenom should be administered within 6 hours, he only received treatment approximately 14 hours later. I strongly believe that the antivenom has a positive effect on the outcome of this bite despite the delay.
His eyesight was not affected in any way and there is almost no visual evidence of his ordeal.