Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital , Prague , Czech Republic.
Clin Toxicol (Phila). 2014 Apr;52(4):258-64. doi: 10.3109/15563650.2014.902066. Epub 2014 Mar 26.
Only one natural venomous snake-the adder viper-lives in the central European region and its bite is usually associated only with mild course of envenoming. Cases of envenoming caused by exotic snakes among their breeders are clinically more important.
The aim of this study was to analyze the epidemiological and clinical aspects of registered venomous bites caused by exotic snakes in the Czech Republic over a period of 15 years (1999-2013).
This is an observational case series. Data have been collected retrospectively from a database and medical charts of the Toxinology Center belonging to the General University Hospital in Prague.
In total, 87 cases of exotic snakebites caused by 34 venomous snake species were registered during the study period, coming from 18 genera of Elapinae, Viperinae, and Crotalinae subfamilies. In the cohort, 29 patients (33.3%) developed systemic envenoming and 17 (19.5%) were treated with antivenom. Ten cases of envenoming (11.5%) were considered as potentially life threatening. No patient died due to envenoming caused by exotic snake bites during the study period. Four illustrative cases of envenoming (Echis pyramidum, Dendroaspis polylepis, Protobothrops mangshanensis, and Proatheris superciliaris) are described in detail.
Bites caused by exotic snakes resulted in serious and life-threatening envenomings in some patients. Early transfer to the Center, antivenom administration, and support of failing organ functions contributed to favorable outcome of victims.
中欧地区仅有一种毒蛇——蝰蛇，其咬伤通常与轻度中毒相关。而饲养员被外来蛇咬伤的情况在临床上更为重要。
本研究旨在分析捷克共和国 15 年来（1999 年至 2013 年）记录的外来毒蛇咬伤的流行病学和临床特征。
这是一项观察性病例系列研究。数据是从布拉格综合医院毒理学中心的数据库和病历中回顾性收集的。
在研究期间，共记录了 87 例由 34 种毒蛇引起的外来蛇咬伤，这些蛇来自 Elapinae、Viperinae 和 Crotalinae 亚科的 18 个属。在该队列中，29 名患者（33.3%）出现全身性中毒，17 名（19.5%）接受了抗蛇毒血清治疗。10 例中毒（11.5%）被认为具有潜在的生命威胁。在研究期间，没有患者因外来蛇咬伤而死亡。详细描述了 4 例中毒病例（Echis pyramidum、Dendroaspis polylepis、Protobothrops mangshanensis 和 Proatheris superciliaris）。
外来蛇咬伤在某些患者中导致严重且危及生命的中毒。早期转至中心、使用抗蛇毒血清和支持衰竭器官功能有助于受害者的良好预后。
