Sirur Freston Marc, Lath Vrinda, A S Chethana, Mohan Ganesh, Shastry Shamee
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Wilderness Environ Med. 2022 Mar;33(1):116-121. doi: 10.1016/j.wem.2021.10.001. Epub 2021 Dec 2.
Snakebite in India is often attributed to the "big 4," for which polyvalent anti-snake venom is effective. Also significant and less known is the burden of other venomous snakes, one of which is Trimeresurus malabaricus. We report a bite to the face of a tree climber by Trimeresurus malabaricus in the Western Ghats of India, which caused severe local envenomation in the form of facial edema and systemic signs of envenomation, including coagulopathy and hypotension. We discuss the role of thromboelastogram, infrared thermography, and routine diagnostics in this case, which led to the administration of Indian-made polyvalent anti-snake venom. The patient recovered and was discharged without any clinically evident physiological or physical dysfunction.
在印度，蛇咬伤通常被认为是由“四大毒蛇”所致，针对这几种毒蛇的多价抗蛇毒血清是有效的。其他有毒蛇类造成的负担也很严重但鲜为人知，其中一种是印度竹叶青。我们报告了一名印度西高止山脉的爬树者被印度竹叶青咬伤面部的病例，此次咬伤导致了严重的局部中毒，表现为面部水肿以及中毒的全身症状，包括凝血病和低血压。我们讨论了该病例中血栓弹力图、红外热成像及常规诊断方法所起的作用，这些检查促使使用了印度产的多价抗蛇毒血清。患者康复并出院，未出现任何临床上明显的生理或身体功能障碍。
