Abstract
A 47-year-old man received a snouted cobra (Naja annulifera) snake bite to his genitals while on holiday in South Africa. His penis and scrotum were noted to be swollen, deep purple in color, and painful on hospital admission. Scrotal necrosis was diagnosed, and he received multiple doses of a non-specific snake venom antiserum and broad-spectrum antibiotics. Although no neurological sequelae developed, he did require hemodialysis due to acute kidney injury. After stabilizing, he was repatriated to the Netherlands for further treatment and has since made a full recovery.
Ours is the first case describing Naja annulifera envenomation of the genitals.
Treatment usually requires antidote and broad-spectrum antibiotic administration.
Some cases also need surgical debridement or more intensive acute care.
Genital function and esthetics have a good chance of recovery with early treatment.
Esthetic surgery should only be performed after the acute phase.
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