Shock can occur after a snakebite but is uncommon. A number of conditions must be considered when trying to identify the cause.
Patient selection: snakebite
Differential diagnosis includes:
(1) anaphylaxis or anaphylactoid reaction to venom
(2) anaphylaxis or anaphylactoid reaction to antiserum (if given)
(3) severe cardiac toxicity
(4) other severe envenomation
(5) sepsis due to infection at bite
(6) sepsis due to intervention for the snakebite (if performed)
(7) myocardial infarction following surprise at being bitten
(8) anaphylaxis or anaphylactoid reaction to prophylactic antibiotic or other drugs given
Administration of antibiotic prophylaxis may reduce the risk of sepsis. The risk of infection is greater if treatment is delayed or if the patient has impaired host defenses (immunodeficient, cirrhosis, other).
Hypotension with or without shock is more common with certain snake venoms such as vipers.
Envenomation is less likely if (1) antivenom is administered promptly AND if (2) appropriate antivenom is used.
