Cases reported "Snake Bites"

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1/4. Unusual neurotoxic envenomations by Vipera aspis aspis snakes in france.

    Vipera aspis aspis (V.a.a.) is the most dangerous poisonous snake in South-Eastern france. The clinical symptoms observed after V.a.a. envenomations involve mostly local signs (pain, edema) associated in the more severe cases with systemic symptoms (gastro-intestinal and cardiovascular manifestations). Since 1992, several unusual cases of moderate and severe 'neurotoxic' envenomations by V.a.a. snakes have been reported in a very localized area in South-Eastern france. Most of the human patients mainly suffered neurological signs owing to cephalic muscle paralysis. Drowsiness and dyspnea were observed for the most severe cases. Envenomed animals suffered respiratory distress and paralysis. The local signs were never as severe as observed after envenomations by vipers in other French regions. Human patients with moderate or severe clinical features received two intravenous injections of Viperfav antivenom, the first dose inducing the decrease of the neurological signs and the second reducing significantly the edema. Neurotoxic components immunologically cross-reacting with toxins from V. ammodytes ammodytes venom from Eastern europe were detected in the blood of all patients suffering neurological symptoms after a V.a.a. bite. The protective efficacy of various antivenoms was evaluated in mice. The existence of geographical variations in the composition of V.a.a. venom emphasizes on the use of polyvalent antivenom in the treatment of viper envenomations in france.
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2/4. Walterinnesia aegyptia envenomation in a 22-year-old female: a case report.

    A 22-year-old woman was bitten on the third finger of her left hand by a Walterinnesia aegyptia (desert black cobra). Local signs included a marked swelling of the entire hand with pain along the left upper limb. Systemic reactions were irritability, fever, tachycardia, ventricular premature beats, nausea and high blood leukocytes count. About 15 h post-envenomation the patient had no symptoms except for a mild swelling of the hand. Despite the severe toxic venom composition of the W. aegyptia, the clinical course of our patient was relatively benign. This could be explained by the snake's behavior and the mechanism by which the venom penetrates the body. A survey of the literature revealed only a few clinical cases reported. Most of the information concerning W. aegyptia was collected from laboratory and animal studies.
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3/4. Envenoming by the viperid snake Eristicophis macmahonii.

    Little is known about the effects of bites by the rare viperid snake Eristicophis macmahonii. A 31-year-old Belgian man, who keeps these animals as a hobby, was bitten on a finger by one of his pets while trying to give it some medicine. The patient developed syncope, followed by a sudden extensive skin rash and massive edema of the arm. He recovered completely, except for a small area of limited tissue necrosis on the bitten finger.
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4/4. neostigmine in the treatment of snake accidents caused by Micrurus frontalis: report of two cases (1).

    Antivenom in order to be effective in the treatment of coral snake accidents must be injected very soon after the bite owing to the rapid rate of absorption of the venom neurotoxins. As this is not always possible, other forms of treatment besides serotherapy must be employed to avoid asphyxia and death. neostigmine and artificial respiration are used for this purpose. neostigmine restores neuromuscular transmission if the venom-induced blockade results from a reversible interaction of its neurotoxins with the end-plate receptors. This is the mechanism of the neuromuscular blockade produced by the venom of M. frontalis snakes from centereastern and southern brazil, and Argentine. neostigmine is able, therefore, to antagonize the blockade, and has been shown to be very effective in the treatment of the experimental envenomation of dogs and monkeys. In the present communication, two cases of M. frontalis accidents treated with antivenom and neostigmine are reported. In both, neostigmine was successful in producing regression of the paralysis, confirming the effectiveness shown in the treatment of the poisoning induced in animals by M. frontalis venom.
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