Successful Use of Cytokine Hemadsorption Filter In Montivipera xanthina Envenomation: A Case Report

Severe local and systemic effects can occur after <i>Montivipera xanthina</i> envenomation. In this case report, we demonstrate the successful use of CytoSorb^® (CytoSorbents, Princeton, New Jersey) hemoadsorption filter to remove snake venom from the systemic circulation in a patient with severe local toxicity after <i>Montivipera xanthina</i> envenomation. A 62-year-old woman was bitten on the fifth finger of her left hand by a viper snake of the genus <i>Montivipera xanthina</i>. She complained of numbness in the left arm, chest pain, and mild shortness of breath. There was a double tooth mark, severe edema, and necrotic appearance on the fifth finger of the left hand. Since it was learned that there would be a delay in the supply of antivenom, CytoSorb^® hemoadsorption therapy was administered to the patient with signs of severe local circulatory disturbance. Since the beginning of the treatment, the patient's tissue perfusion improved significantly. Subsequently, antivenom treatment was also provided and a significant improvement in necrotic tissue appearance and edema was observed in the follow-up. This case demonstrates that early use of hemoadsorption therapy can be effective in snakebite cases with systemic and local clinical manifestations. It is the first case in the literature in which CytoSorb^® filter successfully removed snake venom.