Deinagkistrodon acutus envenomation: a report of three cases
Abstract Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are d...
Published in: | Journal of Venomous Animals and Toxins including Tropical Diseases |
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ftdoajarticles:oai:doaj.org/article:5eddd8ae04fa45a082c808e36378872c 2023-05-15T15:10:09+02:00 Deinagkistrodon acutus envenomation: a report of three cases Chin-Lung Cheng Yan-Chiao Mao Po-Yu Liu Liao-Chun Chiang Shu-Chen Liao Chen-Chang Yang 2017-04-01T00:00:00Z https://doi.org/10.1186/s40409-017-0111-1 https://doaj.org/article/5eddd8ae04fa45a082c808e36378872c EN eng SciELO http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992017000100504&lng=en&tlng=en https://doaj.org/toc/1678-9199 1678-9199 doi:10.1186/s40409-017-0111-1 https://doaj.org/article/5eddd8ae04fa45a082c808e36378872c Journal of Venomous Animals and Toxins including Tropical Diseases, Vol 23, Iss 0 (2017) Coagulopathy Thrombocytopenia Envenomation Deinagkistrodon acutus Snakebite Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 article 2017 ftdoajarticles https://doi.org/10.1186/s40409-017-0111-1 2022-12-31T16:04:15Z Abstract Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6– to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Journal of Venomous Animals and Toxins including Tropical Diseases 23 1 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Coagulopathy Thrombocytopenia Envenomation Deinagkistrodon acutus Snakebite Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 |
spellingShingle |
Coagulopathy Thrombocytopenia Envenomation Deinagkistrodon acutus Snakebite Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 Chin-Lung Cheng Yan-Chiao Mao Po-Yu Liu Liao-Chun Chiang Shu-Chen Liao Chen-Chang Yang Deinagkistrodon acutus envenomation: a report of three cases |
topic_facet |
Coagulopathy Thrombocytopenia Envenomation Deinagkistrodon acutus Snakebite Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 |
description |
Abstract Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6– to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan. |
format |
Article in Journal/Newspaper |
author |
Chin-Lung Cheng Yan-Chiao Mao Po-Yu Liu Liao-Chun Chiang Shu-Chen Liao Chen-Chang Yang |
author_facet |
Chin-Lung Cheng Yan-Chiao Mao Po-Yu Liu Liao-Chun Chiang Shu-Chen Liao Chen-Chang Yang |
author_sort |
Chin-Lung Cheng |
title |
Deinagkistrodon acutus envenomation: a report of three cases |
title_short |
Deinagkistrodon acutus envenomation: a report of three cases |
title_full |
Deinagkistrodon acutus envenomation: a report of three cases |
title_fullStr |
Deinagkistrodon acutus envenomation: a report of three cases |
title_full_unstemmed |
Deinagkistrodon acutus envenomation: a report of three cases |
title_sort |
deinagkistrodon acutus envenomation: a report of three cases |
publisher |
SciELO |
publishDate |
2017 |
url |
https://doi.org/10.1186/s40409-017-0111-1 https://doaj.org/article/5eddd8ae04fa45a082c808e36378872c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Venomous Animals and Toxins including Tropical Diseases, Vol 23, Iss 0 (2017) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992017000100504&lng=en&tlng=en https://doaj.org/toc/1678-9199 1678-9199 doi:10.1186/s40409-017-0111-1 https://doaj.org/article/5eddd8ae04fa45a082c808e36378872c |
op_doi |
https://doi.org/10.1186/s40409-017-0111-1 |
container_title |
Journal of Venomous Animals and Toxins including Tropical Diseases |
container_volume |
23 |
container_issue |
1 |
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1766341208504795136 |