Could a Missed Snake Bite Be the Culprit?
My 92-year-old grandfather has been shuffled between various specialists over the last month due to an alarming set of symptoms including sudden swelling, discomfort, and blistering on his foot. The situation began when he stepped into his garage, experiencing acute pain in his foot. Initially, he thought he had been bitten by a spider, a conclusion that seemed questionable to me. Shortly after this incident, he began to notice significant swelling, widespread bruising, blister formation, and intense pain. Early photos suggested he might have petechiae, but it’s important to note that he was already diagnosed with moderate to severe thrombocytopenia prior to this event and is receiving anticoagulant therapy following a recent stent insertion in his coronary artery. Given these factors, I doubt there was a thorough evaluation of his symptoms or lab results. He was first hospitalized and diagnosed with cellulitis, but after two days, the infectious disease specialist concluded there were no signs of infection and recommended a consultation with a hematologist. The hematologist expressed no worries and advised him to resume antibiotics. Although he has adhered to this treatment for some time, with only limited improvement and increased pain, he ended up being readmitted due to suspected arteritis. The vascular surgeon attempted a stent placement in his leg but stated there was nothing to stent, indicating that his heart wasn’t functioning well enough. Just this week, the cardiologist assessed his heart health and dismissed any concerns about inadequate perfusion. Currently, he is undergoing a tissue biopsy to pinpoint any underlying infectious agent, with plans to modify his antibiotic treatment if necessary, as all previous cultures—both blood and wound—have returned negative. He is feeling drained, frustrated, and in considerable pain. Our family desperately seeks a definitive diagnosis. I can't shake the worry that a potential snake bite could have been overlooked, especially given his age and medical background. Residing on the Texas Gulf Coast, he is in an area where encounters with pit vipers are not unusual. Moreover, he has a complicated medical history that includes a-fibrillation, coronary artery disease with stent insertion, giant cell arteritis resulting in blindness in one eye, and thrombocytopenia. While I am unaware of his precise medications, I know he is taking an anticoagulant, undergoing steroid treatment for GCA, and is currently on antibiotics. Recently, one unit of platelets was also administered to him.
Answers (1)
9/9/2025, 10:10:45 PM
OpenHealth AI
I understand how concerning your grandfather's situation is given his complex medical history and the recent troubling symptoms. You’re correct to want a thorough investigation of any potential underlying causes, including the possibility of a snake bite, especially in a region where encounters with pit vipers are more likely.
Key Points:
- A suspected snake bite should be considered, particularly if symptoms align with venom exposure, but it also may not be the only explanation for his symptoms.
- Other conditions related to his medical history, such as thrombocytopenia and ongoing anticoagulant therapy, could complicate his symptoms and management.
- The process of investigating his condition through tissue biopsies and potential modification of antibiotic treatment is necessary for accurate diagnosis.
Explanation:
Your grandfather's symptoms of swelling, blistering, and pain can be due to various factors, including but not limited to infection, adverse reactions to medications, and complications from his existing conditions (e.g., giant cell arteritis and thrombocytopenia). The presence of petechiae (small red or purple spots caused by bleeding under the skin) is particularly notable in patients with low platelet counts.
While cellulitis was the initial diagnosis, the lack of improvement and the recent discussions regarding arteritis highlight that further evaluation is essential. A snake bite may produce similar symptoms, but without definitive evidence or eyewitness accounts, it could be challenging to confirm this as the cause.
Next Steps:
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Communicate with the Medical Team: Ensure that the healthcare providers are aware of your concern regarding the potential snake bite. Request that they consider all possibilities, including a review of photos of the initial injury and any observations made about the bite site. Sometimes details can be overlooked in complex cases.
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Document Symptoms: Keep a detailed record of your grandfather's symptoms, including any changes in his condition, medication effects, pain levels, and responses to treatments. This information can be useful during discussions with the medical team.
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Enhance Comfort: Encourage him to stay well-hydrated, manage pain with appropriate over-the-counter options as advised by his healthcare provider, and engage in gentle movements as tolerated to avoid stiffness and improve circulation.
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Follow-Up on Biopsy Results: Remain proactive about following up on the results of the tissue biopsy. If they reveal any specific pathogens or conditions, that could lead to targeted treatment.
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Seek Additional Opinions: If you feel the current medical team is not adequately addressing your concerns or if there’s a need for a fresh perspective, seeking a second opinion from another infectious disease specialist or vascular expert may be beneficial.
Your grandfather’s health and comfort are paramount, and I hope that with diligent monitoring and communication with his medical team, clarity and relief from his distressing symptoms can be found soon. Please don’t hesitate to reach out again if you have more questions or need further guidance.
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