Forest pit viper (Bothriopsis bilineata bilineata) bite in the Brazilian Amazon with acute kidney injury and persistent thrombocytopenia

There are six species of Bothriopsis in Latin America, accidents caused by this genus are unusually reported. A 37-year-old man admitted thirty hours after a snakebite to the emergency department of Santarém City Hospital (SCH), northern Brazil. The patient presented local erythema, edema, increased local temperature and blister with serous fluid in the right arm. He developed acute kidney injury (AKI) and prolonged thrombocytopenia. The blood was incoagulable and he was treated with anti-bothropic antivenom and antibiotics. The patient had complete regression of all clinical and laboratory manifestations at varying intervals. The platelet counts returned to normal almost 2 weeks after administration of specific antivenom. The present report is the first accident caused by a snake of forest pit viper (Bothriopsis bilineata) in the Brazilian Amazon forest.