Luo Yi, Mao Yan-Chiao, Liu Po-Yu, Chiang Liao-Chun, Lai Chih-Sheng, Lin Wen-Loung, Huang Chia-Chun
Liuzhou Integrated Chinese and Western Medicine Snake Injury Treatment Center, Liuzhou Traditional Chinese Medicine Hospital, Liuzhou, Guangxi, China.
Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Am J Trop Med Hyg. 2022 Aug 1;107(3):705-8. doi: 10.4269/ajtmh.22-0255.
Ovophis makazayazaya bite is an uncommon cause of snakebite that humans may sustain as a result of the continuous overexploitation of forest habitats and excessive development in Taiwan. Although the Taiwanese government has produced four antivenoms against medically important snakebite accidents, O. makazayazaya is not among the snakes for which an antivenom has been produced. A case of O. makazayazaya snakebite on a patient's right foot, which later swelled into the hip, is reported. In vitro studies have reported that monovalent antivenoms for Gloydius brevicaudus and Trimeresurus albolabris, and polyvalent antivenom for Calloselasma rhodostoma, Daboia siamensis, and T. albolabris show reactivity toward Ovophis venoms. However, these antivenoms are unavailable in Taiwan. Thus, bivalent antivenom for Trimeresurus stejnegeri stejnegeri and Protobothrops mucrosquamatus was used, assuming similar immunoreactivity and a possible para-specific effect of green pit viper antivenom against this Ovophis venom. A favorable outcome was observed, without significant extension in prothrombin time and activated partial thromboplastin time. In addition, no systemic bleeding occurred. Nonetheless, further venom and antivenom evaluations should ascertain the efficacy of this para-specific antivenoms against this crotaline snakebite.
台湾竹叶青蛇咬伤是一种不常见的蛇咬伤原因，由于台湾森林栖息地的持续过度开发和过度发展，人类可能会遭受这种咬伤。尽管台湾政府已经生产了四种针对具有医学重要性的蛇咬伤事故的抗蛇毒血清，但台湾竹叶青蛇并不在已生产抗蛇毒血清的蛇类之中。本文报告了一例患者右脚被台湾竹叶青蛇咬伤，随后肿胀至臀部的病例。体外研究报告称，短尾蝮和白唇竹叶青的单价抗蛇毒血清，以及圆斑蝰、泰国圆斑蝰和白唇竹叶青的多价抗蛇毒血清对台湾竹叶青蛇毒有反应。然而，这些抗蛇毒血清在台湾无法获得。因此，使用了竹叶青指名亚种和菜花原矛头蝮的双价抗蛇毒血清，假定绿蝮蛇抗蛇毒血清对这种台湾竹叶青蛇毒具有相似的免疫反应性和可能的类特异性效应。观察到了良好的结果，凝血酶原时间和活化部分凝血活酶时间没有明显延长。此外，没有发生全身性出血。尽管如此，进一步的毒液和抗蛇毒血清评估应确定这种类特异性抗蛇毒血清对这种蝰蛇咬伤的疗效。
