蹲伏的饲养员，隐藏的龙：一例科莫多龙咬伤病例
Crouching Zookeeper, Hidden Dragon: A Case of a Komodo Dragon Bite.
作者信息
Friedman Nathan A, Seltzer Justin A, Winkler Garret A, Noste Erin, Montilla Henry, Clark Richard F
机构信息
Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, San Diego, California; Veterans Affairs San Diego Healthcare System, San Diego, California.
Department of Emergency Medicine, University of California, San Diego, San Diego, California.
出版信息
J Emerg Med. 2023 Feb;64(2):186-189. doi: 10.1016/j.jemermed.2022.12.001. Epub 2023 Feb 21.
BACKGROUND
The Komodo dragon (Varanus komodoensis) is the world's largest living lizard and exists in private captivity worldwide. Bites to humans are rare and have been proposed to be both infectious and venomous.
CASE REPORT
A 43-year-old zookeeper was bitten on the leg by a Komodo dragon and suffered local tissue damage with no excessive bleeding or systemic symptoms to suggest envenomation. No specific therapy was administered other than local wound irrigation. The patient was placed on prophylactic antibiotics and on follow-up, which revealed no local or systemic infections, and no other systemic complaints. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although venomous lizard bites are uncommon, prompt recognition of possible envenomation and management of these bites is important. Komodo dragon bites may produce not only superficial lacerations but also deep tissue injury, but are unlikely to produce serious systemic effects; whereas Gila monster and beaded lizard bites may cause delayed angioedema, hypotension, and other systemic symptoms. Treatment in all cases is supportive.
背景
科莫多巨蜥（Varanus komodoensis）是世界上现存最大的蜥蜴，在世界各地的私人圈养环境中都有存在。对人类的咬伤很罕见，有人认为其咬伤既具有传染性又有毒性。
病例报告
一名43岁的动物园饲养员被一只科莫多巨蜥咬伤腿部，局部组织受损，但无过度出血或提示中毒的全身症状。除了局部伤口冲洗外，未给予特殊治疗。患者接受了预防性抗生素治疗并进行随访，结果显示无局部或全身感染，也无其他全身不适。为什么急诊医生应该了解这个情况？：尽管有毒蜥蜴咬伤并不常见，但迅速识别可能的中毒情况并对这些咬伤进行处理很重要。科莫多巨蜥的咬伤不仅可能造成表浅撕裂伤，还可能导致深部组织损伤，但不太可能产生严重的全身影响；而希拉毒蜥和珠状蜥蜴的咬伤可能会引起迟发性血管性水肿、低血压和其他全身症状。所有病例的治疗均为支持性治疗。
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