A fatal bite from the burrowing asp Atractaspis corpulenta (Hallowell 1854)

•The first fatality following the bite of Atractaspis corpulenta is described.•The precise mechanism of death was unclear from the clinical record.•Autopsy findings were largely non-specific – could not exclude anaphylaxis.•Clinical effects and mode of action of Atractaspis venoms are briefly reviewed.

Bites from the various species of Atractaspis are a common occurrence in Africa but deaths are very unusual. Of the 19 described species, the clinical effects of the bite of only seven have been described, and in only three (Atractaspis irregularis, Atractaspis microlepidota and Atractaspis engaddensis) have fatalities been documented. A case of envenomation is described following a bite to a finger by Atractaspis corpulenta, which resulted in sudden death approximately two and a half hours later. The victim received antivenom and although anaphylaxis to this cannot be ruled out, we consider it to be unlikely to be the cause of death. A late autopsy was performed and the findings and their interpretation are discussed. The previous case fatalities, toxic fractions and clinical effects of Atractaspis venom are briefly reviewed.