First Video-Documented Vine Snake (Thelotornis Capensis) Envenomation in a Healthy Adult: A Rare Case Report from South Africa

Vine snake (Thelotornis capensis) envenomation is rare but can cause life-threatening coagulopathy. We report the 10th documented case of envenomation: a 42-year-old male who misidentified a vine snake as a juvenile python and sustained a bite while filming snake handling. Initial laboratory investigations showed complete incoagulability within 28 minutes of the bite, with normal vital signs and minimal local symptoms. The patient later developed frank hematuria, highlighting the delayed onset of systemic bleeding typical of venom-induced consumptive coagulopathy. No specific antivenom exists for venom from the Thelotornis genus. Management was supportive, with close monitoring of coagulation parameters; blood products were planned if bleeding progressed, but were not ultimately required. The patient self-discharged against medical advice despite ongoing coagulopathy, but ultimately recovered fully without sequelae. This case reinforces the need for clinicians to be aware of delayed coagulopathy and the importance of supportive care in vine snake envenomation.