A reptile holder based in the Czech Republic was bitten into his hand and foot by the Northeast saw-scaled viper (Echis pyramidum). The person arrived at the health institution after twenty hours for anuria.
Despite the antivenom against the Asian Echis carinatum – the Echis pyramidum’s close relative – was readily available and administered repeatedly, the envenoming continued to develop with subsequent coagulopathy, hepatopathy and respiratory failure.