Kopec Kathryn T, Yen May, Bitner Matthew, Evans C Scott, Gerardo Charles J
Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (Dr Kopec); Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (Dr Yen); Division of Emergency Medicine, Duke University Medical Center, Durham, NC (Dr Gerardo).
Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (Dr Kopec); Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (Dr Yen); Division of Emergency Medicine, Duke University Medical Center, Durham, NC (Dr Gerardo).
Wilderness Environ Med. 2015 Dec;26(4):488-90. doi: 10.1016/j.wem.2015.07.002. Epub 2015 Oct 1.
Compared with other crotaline envenomations, copperhead envenomations have historically been reported as having less severe hematologic venom effects and rarely hemorrhage. We report a case of clinically significant gastrointestinal bleeding after a copperhead (Agkistrodon contortrix) envenomation. A 52-year-old woman with a history of systemic lupus erythematosus was bitten on her right medial ankle after which hypofibrinogenemia and hematochezia developed. The symptoms resolved after repeated administration of Crotalidae polyvalent immune Fab (ovine) antivenom. She was discharged without further complications 2 days later. Although copperhead envenomations are classically considered less severe than other crotaline envenomations, this case demonstrates the potential of the venom to produce clinically significant hematologic effects.
与其他蝰蛇科蛇咬伤中毒相比，历史报道称铜头蛇咬伤中毒的血液毒性作用较轻，很少发生出血。我们报告一例铜头蛇（美洲矛头蝮）咬伤中毒后出现具有临床意义的胃肠道出血的病例。一名有系统性红斑狼疮病史的52岁女性右侧内踝被咬伤，随后出现低纤维蛋白原血症和便血。反复给予抗蝰蛇毒血清（羊）后症状缓解。两天后她出院，无进一步并发症。尽管传统上认为铜头蛇咬伤中毒比其他蝰蛇科蛇咬伤中毒症状较轻，但该病例显示了这种蛇毒产生具有临床意义的血液学效应的可能性。
