Clinical manifestations of alpine pit viper (Trimeresurus gracilis) bites.

IF 3 3区 医学 Q2 TOXICOLOGY
Min-Hui Chen, Hsiao-Feng Hu, Szu-Hsien Wu, Yen-Wen Chen, Yen-Chia Chen
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引用次数: 0

Abstract

Introduction: The alpine pit viper, Trimeresurus gracilis, is an endemic species in Taiwan. The incidence of human envenoming is rare.

Case summaries: We present three events in two patients bitten by Trimeresurus gracilis. In the first patient, envenoming inflicted pain, local bleeding, hemorrhagic bulla, and progressive swelling, leading to necrosis of the bite wound. In the second patient, the two snakebites caused pain and progressive swelling. There were no systemic effects such as organ damage or neurological deficits observed. A paraspecific antivenom against Trimeresurus stejnegeri and Protobothrops mucrosquamatus was used to treat both patients, with a favorable outcome in each.

Discussion: Combined with the clinical manifestations of two previously reported cases of Trimeresurus gracilis envenoming, the known effects of Trimeresurus gracilis venom in humans include local toxicities, severe soft-tissue damage, compartment syndrome, and coagulopathy without spontaneous systemic bleeding. The paraspecific antivenom, which has demonstrable cross-neutralization effects in animal studies, appeared to be effective against the local toxicities as the patients showed prompt cessation of the progression of their swelling.

Conclusions: The knowledge of clinical manifestations and management approaches to Trimeresurus gracilis envenoming is helpful for patient care. The use of the paraspecific antivenom should be considered in managing such envenoming.

高山蝮蛇(Trimeresurus gracilis)咬伤的临床表现。
简介高山蝮蛇(Trimeresurus gracilis)是台湾的特有物种。人类被毒蛇咬伤的情况非常罕见:我们介绍了两名被高山蝮蛇咬伤的患者的三个病例。第一例患者被毒蛇咬伤后出现疼痛、局部出血、出血性鼓包和进行性肿胀,导致咬伤处坏死。第二名患者被两条蛇咬伤,造成疼痛和进行性肿胀。没有观察到器官损伤或神经功能障碍等全身性影响。对这两名患者都使用了针对Trimeresurus stejnegeri和Protobothrops mucrosquamatus的副特异性抗蛇毒血清,治疗效果良好:讨论:结合之前报道的两例Trimeresurus stejnegeri和Protobothrops mucrosquamatus蛇毒中毒的临床表现,已知Trimeresurus stejnegeri和Protobothrops mucrosquamatus蛇毒对人类的影响包括局部中毒、严重软组织损伤、隔室综合征和凝血功能障碍,但无自发性全身出血。副特异性抗蛇毒血清在动物实验中具有明显的交叉中和作用,对局部毒性似乎有效,因为患者的肿胀进展迅速停止:结论:了解蝙蝠螫伤的临床表现和处理方法有助于患者的护理。在处理此类中毒时,应考虑使用副特异性抗蛇毒血清。
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来源期刊
Clinical Toxicology
Clinical Toxicology 医学-毒理学
CiteScore
5.70
自引率
12.10%
发文量
148
审稿时长
4-8 weeks
期刊介绍: clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.
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