21 August 2020
: Case report 
The Role of Point-of-Care Ultrasound (POCUS) in Envenomation by a Desert Viper
Challenging differential diagnosis, Unusual setting of medical care
Amr Elmoheen1EFG*, Waleed Awad Salem1BC, Galal Al Essai1BD, Dharmesh Shukla1BDEF, Ankush Pathare1B, Stephen H. Thomas123CDEFDOI: 10.12659/AJCR.924306
Am J Case Rep 2020; 21:e924306
Table 1. Baseline laboratory testing at the presentation and throughout the course of treatment.
| Normal range | Patient labs at presentation 3 h postenvenomation | Patient labs at 10 h postenvenomation | Patient labs 4 h postanti-venom administration | Patient labs before discharge | |
|---|---|---|---|---|---|
| CBC | |||||
| WBC | (4–10)×10/μL | 15.6 | 16.6 | 19.2 | 8.3 |
| Hemoglobin | (13–17) g/dL | 14.5 | 15.8 | 15.2 | 12.2 |
| Platelets | (150–400)×10/μL | 199 | 115 | 115 | 197 |
| Electrolytes | |||||
| Sodium | (135–145) mmol/L | 137 | 135 | 137 | 135 |
| Potassium | (3.6–5.1) mmol/L | 5 | 4 | 3.7 | 4.8 |
| Chloride | (96–110) mmol/L | 105 | 106 | 110 | 105 |
| Renal panel | |||||
| Creatinine | (64–110) μmol/L | 92 | 80 | 79 | 72 |
| Urea | (3.0–9.20) mmol/L | 5.35 | 5.7 | 5.2 | 5.6 |
| Liver function | |||||
| AST | (5–34) U/L | 23 | 34 | 39 | 20 |
| ALT | (0–55) U/L | 27 | 26 | 23 | 21 |
| Total bilirubin | (3.4–20.5) μmol/L | 7 | 18 | 20 | 14 |
| Albumin | (35–50) g/L | 42 | 39 | 30 | 36 |
| Coagulation | |||||
| PT | (7.8–9.9) s | 10.3 | 44.7 ↑ | 20.7 | 9.7 |
| APTT | (25.3–33.8) s | 18.6 | 35.1 ↑ | 41.7 | 29.8 |
| INR | (0.8–1.0) | 1.1 | 4 ↑ | 2 | 1 |
| D-Dimer | (0.00–0.55) mg/L | – | >34.18 | >34.18 | – |
| Fibrinogen | (1.80–3.50) g/L | – | <0.07 | <0.7 | – |
| Lactic acid | (0.5–1.6) | 3.7 | 2.9 | – | – |
| CBC – complete blood count; WBC – white blood cells; AST – aspartate aminotransferase; ALT – alanine aminotransferase; PT – prothrombin time; APTT – activated partial thromboplastin time; INR – international normalized ratio. | |||||