Severe coagulopathy associated with white-lipped green pit viper bite.

The authors report a case of Trimeresurus albolabris (white-lipped green pit viper) bite in a 6-year-old girl living in rural Yuen Long. Despite repeated use of Agkistrodon halys antivenin, the patient developed severe coagulopathy with defibrination syndrome on the fourth day of envenomation, which was also refractory to therapy with fresh frozen plasma. When treatment was switched to green pit viper antivenin, the coagulopathy resolved promptly. The case is illustrative of the potential lethality to children of snakebites in Hong Kong and suggests that the A halys antivenin may not be effective for the treatment of T albolabris bites.