Haemotoxic snakebite in rural KwaZulu-Natal, South Africa

To the Editor : We would like to comment on the case report published in the May 2016 issue of SAMJ of a suspected boomslang bite presenting with severe haematemesis. We question the diagnosis of a boomslang bite. Firstly, the clinical manifestations as described do not correlate witha boomslang bite. Boomslang bite results in severe consumptive coagulopathy with bleeding from multiple sites and would not be confined to a single organ system as described in the case report. Haemorrhagic gastritis and ulcers also do not fit the clinical picture. These findings may be better explained by chronic heavy alcohol consumption.