1/88. Neurotoxicity associated with suspected southern Pacific rattlesnake (crotalus viridis helleri) envenomation.An 18-year-old man was bitten on the hand by a snake he believed to be a Southern Pacific rattlesnake (crotalus viridis helleri). Within minutes he developed generalized weakness, difficulty breathing, diplopia, dysphagia, and dysphonia. Neurological examination revealed ptosis and decreased motor strength. These symptoms partially improved after administration of Antivenin (Crotalidae) Polyvalent, but the patient continued to have difficulty walking for several days due to weakness. In addition to neurological symptoms, the patient also experienced pain immediately after the bite occurred and rapid swelling of the entire extremity, which extended beyond the shoulder. He complained of a metallic taste in his mouth and developed intense muscle fasciculations of the face, tongue, and upper extremities, which lasted for 2 days and did not improve with antivenin treatment. He exhibited laboratory evidence of coagulopathy and rhabdomyolysis. Although neurotoxins are known to occur in the venom of certain populations of rattlesnakes, only a few clinical reports describing severe neurological symptoms appear in the literature. To our knowledge, this is the first reported case of neurotoxicity associated with a suspected Southern Pacific rattlesnake envenomation.- - - - - - - - - - ranking = 1keywords = coagulopathy (Clic here for more details about this article) |
2/88. disseminated intravascular coagulation after cerastes vipera envenomation in a 3-year-old child: a case report.This study presents a case of severe disseminated intravascular coagulation (DIC) in a 3-year-old child following envenomation by the snake, Cerastes vipera. A literature search revealed very few similar cases. We describe a child who was bitten in his left foot by a snake identified as a C. vipera. Initial symptoms were relatively benign. Local signs included a hemorrhagic vesicle at the site of the bite with marked swelling of the entire leg. Twenty-four hours later, the child developed severe bleeding due to DIC, which lasted 5 days and required repeated administration of blood and blood products and total exchange transfusion. The patient was discharged from the hospital after 7 days in good condition. To the best of our knowledge, severe DIC following envenomation by a C. vipera has not been previously described in the literature. Treatment was essentially supportive. The case report indicates that a specific antivenin against this snake's venom should be made available in our area.- - - - - - - - - - ranking = 0.91880516720237keywords = intravascular coagulation, coagulation, intravascular (Clic here for more details about this article) |
3/88. Severe systemic effects of Merrem's hump-nosed viper bite.OBJECTIVE: To report unpredictable severe systemic effects of hump-nosed viper envenomation. SETTING: Medical unit, General hospital, Anuradhapura. methods: The clinical outcome of seven patients bitten by Merrem's hump-nosed viper were monitored until recovery or death. Limited autopsies were performed on the latter. Offending snakes were positively identified by medical officers and in one instance by a herpetologist. CONCLUSION: Merrem's hump-nosed viper bites, caused an array of potentially fatal systemic manifestations. One patient developed neurological effects, severe Raynaud's syndrome leading to ascending gangrene of distal limbs and adult repiratory distress syndrome (ARDS), in addition to the known complications of severe renal cortical necrosis and haemostatic dysfunction. Two patients who developed acute renal failure and prolonged coagulopathy recovered completely. The combination of extensive renal cortical necrosis, disseminated intravascular coagulation, and ARDS proved fatal in three.- - - - - - - - - - ranking = 1.1837610334405keywords = coagulopathy, intravascular coagulation, coagulation, intravascular (Clic here for more details about this article) |
4/88. Rattlesnake envenomations: unusual case presentations.Rattlesnake envenomations are common in some areas of the united states. Although fatal rattlesnake envenomations are rare and usually preventable, morbidity may be significant. patients may present with localized edema, hypotension, coagulopathy, or thrombocytopenia. patients with progressive swelling or severe coagulopathy are typically treated with Crotalidae polyvalent antivenin. We present a series of 4 patients with unusual complications of rattlesnake envenomation to illustrate the wide spectrum of disease that may be encountered. These case presentations include anaphylaxis to rattlesnake venom, an acute airway emergency, progressive and marked edema with a large pleural fluid collection, and death.- - - - - - - - - - ranking = 2keywords = coagulopathy (Clic here for more details about this article) |
5/88. Snake bite presenting as acute myocardial infarction, ischaemic cerebrovascular accident, acute renal failure and disseminated intravascular coagulopathy.An unusual presentation of a viperine snake bite presenting with ischaemic damage to the major organs like brain and heart leading to cerebrovascular accident and acute myocardial infarction along with acute renal failure and disseminated intravascular coagulopathy (DIC) is described in this report.- - - - - - - - - - ranking = 5.0764795083852keywords = coagulopathy, intravascular (Clic here for more details about this article) |
6/88. Fatal cerebral hemorrhage and acute renal failure after young bothrops jararacussu snake bite.An unusual case of a patient developing severe coagulopathy disorder and a clinical picture of cerebral hemorrhage and acute renal failure after young bothrops jararacussu snake bite is reported. The mechanisms of snake venom-induced injury are discussed and similar cases in literature are revised and compared. The use of bothropic-crotalus antivenom in severe B. jararacussu envenomation is discussed.- - - - - - - - - - ranking = 1keywords = coagulopathy (Clic here for more details about this article) |
7/88. Intestinal ischemia after bushmaster (Lachesis muta) snakebite--a case report.After a snakebite by the Costa Rican bushmaster Lachesis stenophrys, a 64-year-old patient developed cardiovascular shock and coagulopathy. After intensive care and antivenom treatment, he was discharged after 4 days but had to be hospitalised again 3 days later because of abdominal pain and bowel obstruction. An emergency laparotomy revealed a necrotic ileum and caecum, and an obstruction of the superior mesenteric artery. Until now, this type of intestinal ischemic complication after a snakebite has not been reported in the literature. The effects of bushmaster venom are discussed.- - - - - - - - - - ranking = 1keywords = coagulopathy (Clic here for more details about this article) |
8/88. Two cases of bites by the black-bellied swamp snake (Hemiaspis signata).We report two cases of envenomation by the black bellied swamp snake, Hemiaspis signata, with expert identification of the snakes. In the first case a 12 year old boy, who after the removal of the pressure immobilisation bandage, developed decreased fibrinogen levels and positive cross-linked fibrinogen degradation products (XDPs), but normal prothrombin time and activated partial prothrombin time. These changes resolved over 8h with no treatment. In the second case a 7 year old boy had local pain, swelling and axillary lymphadenopathy following the bite. These cases indicate the potential for coagulopathy and local symptoms following bites by large specimens of H. signata in young children.- - - - - - - - - - ranking = 1keywords = coagulopathy (Clic here for more details about this article) |
9/88. Mild snake envenomation.Snake bite envenomation typically requires treatment with effective first aid and antivenom. There is a spectrum of envenomation seen, which includes mild envenomation, but this has not been reported previously. We report two cases of mild envenomation and describe the changes in laboratory coagulation values. The patients had a benign clinical course without receiving antivenom. We strongly recommend that if clinicians are considering not treating any envenomated patients with antivenom, they do so only on expert advice.- - - - - - - - - - ranking = 0.027584585568829keywords = coagulation (Clic here for more details about this article) |
10/88. Investigation of coagulopathy in three cases of tiger snake (Notechis ater occidentalis) envenomation.AIMS: To investigate the severe coagulopathy (fibrinogen < 1.0 g/l) that occurs in some cases of tiger snake envenomation. Specifically, to determine the concentration of clotting factors on presentation and during resolution of the coagulopathy. methods: Clotting factors II, V, VII, VIII, IX, XI were assayed on all coagulation samples received from three successive cases of severe tiger snake envenomations. Assays were performed at dilutions of 1:5 and 1:10 using an MLA 1600c automated coagulation analyser and Dade Behring factor-deficient plasmas, controls and standards. D-dimers were assayed using Agen Dimertest latex kit, fibrinogen was determined using the Clauss method and platelet counts were performed using Abbott Cell-Dyn 4000 analysers. RESULTS: The activity of the coagulation factors of the intrinsic pathway was reduced (factor viii < 44% in all cases, factor ix < 33%, factor xi < 52% in Cases 1 and 2) but the results for the two dilutions were not parallel. In one case, factor viii and factor ix activity increased 2-fold prior to the administration of blood products. Treatment with blood products corrected the coagulation indices in two out of the three cases but factor V remained low in one case (25%). CONCLUSIONS: The non-parallel results and the apparent increase in factor levels prior to treatment may result from the transient presence of an inhibitor to factors VIII, IX and XI in cases of tiger snake envenomation. Insight into the effects of snake venom on individual coagulation factors could be beneficial when considering new treatments for the coagulopathy induced by snake envenomation.- - - - - - - - - - ranking = 7.1379229278441keywords = coagulopathy, coagulation (Clic here for more details about this article) |
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