A bite | Figure 1

anja6

Medical Resident

A bite

I do not have any pictures of a case, but I promise it is interesting.

It was summer. I was on a mission with the army on a mountain. We were accommodated in tents and sleeping in bags.

Early in the morning, one of the members of the unit came to my ambulance. He was complaining about a problem with his genital. He said it was red and itching. He was being shy and did not want to show me what it looked like.

I thought the reason for the problem was probably poor hygiene because of the bad terms on the field, all together with constant sweating in those high temperatures. I gave him Canesten cream, instructions for reaching a higher level of hygiene, and told him to come back in the evening.

Two hours later, the patient came again. This time he looked more worried. He told me it wasn't itchy anymore; it was painful now. He again did not want to let me look at his genital until I demanded he take off his clothes.

What I saw made me terrified, really. His genital was all pale and swollen. I saw two little dots on top of a glance of the penis. There was no blood around the dots and no swelling. I asked if the patient had any birthmark in that area and he denied it. The patient denied seeing those dots before and did not want to say if he knew the reason for the problem. He just said that he woke up with the swelling.

The dots looked to me like a bite. Since we were in nature, I thought it could be a snake bite. I sent him to the hospital for antibiotics, tetanus, and serum.

The patient stayed at the hospital for a day. Laboratory findings showed no signs of snake venom.

After getting out of the hospital, the patient came back to me for a control examination. The swelling was smaller, but I saw on the medial of his legs changes that looked like capillary bleedings. Those changes were getting smaller and brighter as they were getting from the genital area closer to the feet.

What do you think about the diagnosis?

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