A RARE CASE OF REACTIVE ARTHRITIS SECONDARY TO RUSSEL’S VIPER BITE

Abstract

In tropical areas, Russell's viper (Daboia russelii) bite envenomation poses a serious threat to public health since it can result in coagulopathy, severe renal failure, and neurotoxicity. In tropical areas, Russell's viper (Daboia russelii) bite envenomation poses a serious threat to public health since it can result in coagulopathy, severe renal failure, and neurotoxicity. Rarely, inflammatory joint conditions like reactive arthritis occur as sequelae. This report details a 61-year-old farmer presenting with reactive arthritis following a Russell's viper bite on his right heel. Initial management included anti-snake venom therapy and ICU care for coagulopathy. On day four, the patient developed high-grade fever, knee swelling, and pain, followed by ankle involvement. Laboratory findings showed elevated inflammatory markers, including leukocytosis, ESR, and CRP, while autoimmune and infectious markers were negative. Synovial fluid analysis excluded septic arthritis, supporting an inflammatory etiology. Treatment involved NSAIDs and intravenous dexamethasone, leading to marked clinical improvement and symptom resolution. This case emphasizes the need for recognizing rare complications like reactive arthritis in snakebite victims. A thorough clinical evaluation and multidisciplinary approach are essential for early diagnosis and management. Limited literature exists on reactive arthritis secondary to snakebite envenomation, emphasizing the importance of reporting such cases. Further research is warranted to understand the pathophysiological link between snake venom and post-inflammatory joint conditions to improve diagnostic and therapeutic strategies.