A Fatal Snakebite with Nephropathy and Hepatopathy: A Case Report

Snakebite is a significant public health problem and a common medical emergency, especially in tropical countries like India, where it is also an occupational hazard. Despite its impact, snakebite-related deaths are often underestimated. In India, an estimated 40,000 to 50,000 deaths occur annually due to snakebites, with the majority happening in rural areas lacking access to quality medical care. Snake venoms exhibit diverse pathophysiological effects and can be classified as hemotoxic, neurotoxic, or cytotoxic. These toxins often lead to multiorgan failure and death. Snake venomation can result in various potentially fatal clinical toxin syndromes, including venom-induced consumption coagulopathy (VICC) with hemorrhage, acute renal failure (ARF), and hemolysis. Histopathological examination plays a crucial role in establishing the cause of death in snakebite cases, where other circumstantial evidence is unavailable. Though nephropathy and VICC are a common cause of death in snakebite, literature on hepatopathy and pathological effects of envenomation on the liver is scarce. This report presents autopsy findings of a 36-year-old male who succumbed to disseminated intravascular coagulation (DIC), thrombotic microangiopathy, nephropathy, and hepatopathy, ultimately leading to multiorgan failure and subsequent death. While the effects of snake venom on kidneys have been extensively documented, the pathological effects of envenomation on the human liver are lacking and hence this case is presented here.