While urinating in an open field in India, a farmer's penis was struck by a Levantine viper (Macrovipera lebetina). The "gunas," a local name for the cold-blooded culprit, injected venom through two fang entry points just behind the glans.
The man, 46, arrived at the hospital 3 hours after the attack with a "grossly swollen penis and formation of hemorrhagic bullae" at the puncture sites, Tajamul Hussain, MD, and Rafi A. Jan, MD, of Sher-i-Kashmir Institute of ľֱ Sciences in Srinagar, India, reported in the .
Fortunately, the man's vital signs were stable, but labs showed poor clotting action with a prothrombin time of 17 seconds, and a low fibrinogen level of 80 mg per deciliter, and a somewhat normal activated partial thromboplastin (APPT) time of 34 seconds.
Doppler ultrasound of the veins and arteries of the penis revealed normal flow throughout.
A polyvalent antivenom effective against cobra, common krait, and viper was administered, and 36 hours later, the patient's labs showed normal coagulation function.
He still had swelling for what had to be a difficult 4 days, and necrotic tissue formed black scabs at the puncture sites. But, thankfully, at the 2-week follow-up, the physicians wrote that the man had completely recovered.
of a broad-spectrum antivenom in Africa, specifically, where the single drug is used to treat bites from 10 different snakes.
On the plus side, we now know a penis can be saved after a viper attack, and to be careful not to pee on snakes.
For more Gross Anatomy:
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Primary Source
New England Journal of Medicine
Hussain T, et al "A viper bite" N Engl J Med 2015; DOI: 10.1056/NEJMicm1410237.