Blumenthal Ryan, Scholtz Pieter Evelyn Pienaar, Shuttleworth Jenna-Lee
From the Department of Forensic Medicine.
Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Am J Forensic Med Pathol. 2019 Dec;40(4):356-360. doi: 10.1097/PAF.0000000000000496.
We present the case of a male adult who was admitted to an emergency department after having sustained envenomation from a black mamba (Dendroaspis polylepis). According to the available history, a single fang hooked his right index finger, post venom extraction. After administering antivenom in the accident and emergency department, further vials were transfused in the intensive care unit. An urticarial rash was noted, which was thought to be related to the antivenom. The victim remained in a coma for 3 days, after which he was declared dead. A medicolegal postmortem examination was performed 4 days after death because of logistical reasons. The complexities of differentiating acute envenomation from black mamba versus early acute reactions to polyvalent antivenom administration are highlighted in this case study.
我们报告一例成年男性病例，该患者被黑曼巴蛇（Dendroaspis polylepis）咬伤后被紧急送往急诊科。根据现有的病史，在毒液提取后，一根毒牙钩住了他的右手食指。在急症室注射抗蛇毒血清后，重症监护病房又输注了更多瓶抗蛇毒血清。患者出现了荨麻疹皮疹，认为这与抗蛇毒血清有关。受害者昏迷了3天，之后被宣布死亡。由于后勤原因，在死亡4天后进行了法医尸检。本病例研究突出了区分黑曼巴蛇急性中毒与多价抗蛇毒血清早期急性反应的复杂性。
