Arvind Singh Kushwaha, Dept. of Community Medicine, Field Health Organisation, Jammu, India.
Abhishek Pathak, Dept. of Internal Medicine, Military Hospital, Jammu, India.
Neha Kushwaha, Davao Medical School Foundation, Davao, Philippines.
Animal human interaction is known since ages as friends and foes alike. While dog bite, snakebites are common, bites from animals like monitor lizard are very uncommon. One such rare case of monitor lizard bite that reported to a peripheral zonal hospital which succumbed due to complications is being reported here. Case: 28 year old male with no known prior co - morbidities presented with bite of monitor lizard at 1000 hrs in the morning. Initially there was minimal pain, local swelling and tenderness over the site of bite. There was no ooze or bleeding. He was taken to a local hospital where besides local wound toilet, he was given injection TT, analgesics and anti - inflammatory drugs. Swelling, however progressively increased. By next day morning, he was febrile with signs of cellulitis in the form of local erythema, swelling and tenderness. He was put on antibiotics, analgesics and supportive management and close monitoring for development of any complications. By evening he had developed Compartment Syndrome for which emergent fasciotomy up to the knee joint was done. Post - fasciotomy the urine output started decreasing and by evening inspite of adequate fluid resuscitation and diuretics, the patient became anuric. He had developed features of azotemia in the form of repeated vomiting, no appetite and anuria. He was taken up for urgent hemodialysis on second day of admission. Broad spectrum antibiotics and guided fluid management was being done. His condition failed to improve in spite of 6 sessions of hemodialysis over next six days. In view of his worsening cellulitis and gangrene of the lower limb he had to be taken up for below knee amputation as a life saving measure. However, patient continued to deteriorate and he succumbed to his illness on the 10th day after the bite.
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