Abstract
Objective: To report the case of a patient who developed massive rhabdomyolysis and acute hepatitis secondary to a severe crotalic accident. Case details: A 27-year-old male patient from a rural area was victimized by a snake bite while working in the field. He was admitted to the hospital with a severely compromised clinical condition, decreased level of consciousness, hypotension and fever. On admission, biochemical laboratory tests and urine summary showed massive rhabdomyolysis, acute hepatitis, and sepsis of dermal focus, and the electrocardiogram showed apiculate and diffuse T waves. Final considerations: Rhabdomyolysis is a classic event of the crocal accident, however, when massive, it categorizes an unusual evolution capable of inducing acute liver injury. Hepatotoxicity is rare and can be directly associated with the venomous venom and therefore appear in isolation; or be aggravated by rhabdomyolysis. Thus, new complementary tests focusing on the evaluation of liver integrity should be inserted in the diagnostic management. After the recognition of acute hepatitis, the preservation of liver function should be one of the goals in the course of therapy to ensure a better prognosis and reduce mortality rate.