One Bite, Two Severe Envenomations Despite Antivenom Therapy: A Case Report.

This case report describes a 12-year-old child who was bitten by a cobra and developed two distinct systemic neurotoxic episodes, 19 h apart, along with severe local envenoming, despite receiving appropriate treatment with antivenom and making a full recovery. It also highlights the use of neostigmine for severe symptoms and emphasizes the importance of prompt wound care to prevent long-term complications. A potentially life- and limb-threatening event was successfully avoided through an inter-departmental approach.