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烙铁头蛇(杰顿氏竹叶青)和喜马拉雅矛头蝮(喜马拉雅矛头蝮)咬伤:来自印度东北部的中毒病例报告,通过国家级中毒控制中心的远程咨询进行管理。

Protobothrops jerdonii (Jerdon's pit viper) and Protobothrops himalayanus (Himalayan lance-headed pit viper) bites: Clinical report on envenomings from North-East India, managed through remote consultation by a national-level Poison control center.

机构信息

Poison Control Center, Department of Medicine, Christian Medical College (CMC), Vellore, Tamil Nadu, 632004, India.

181 Military Hospital, Tenga, Arunachal Pradesh, 790116, India.

出版信息

Toxicon. 2024 May 6;242:107704. doi: 10.1016/j.toxicon.2024.107704. Epub 2024 Mar 31.

Abstract

Members of the genus Protobothrops are amongst the more than twenty-eight range-restricted Indian pit viper species. Their bites and envenomings are rarely documented from India. Pit viper envenomings can be challenging to treat in the Indian setting, since available antivenoms do not satisfactorily neutralize their venoms. Herein, we present the first Indian reports on bites and envenoming by Protobothrops jerdonii and Protobothrops himalayanus resulting in local effects, coagulopathy and acute kidney injury in the case of the former and possible mild, isolated coagulopathy in the case of the latter; and discuss management-related challenges in the context of absent specific antivenoms.

摘要

尖吻蝮属的成员是印度二十八种范围受限的印度烙铁头蛇种之一。它们的咬伤和中毒在印度很少有记录。由于现有的抗蛇毒血清不能有效地中和它们的毒液,因此在印度,处理烙铁头蛇中毒可能具有挑战性。在此,我们首次报告了因尖吻蝮和喜马拉雅烙铁头蛇咬伤和中毒导致局部效应、凝血障碍和急性肾损伤的病例,前者可能表现为轻微、孤立的凝血障碍;并讨论了在缺乏特异性抗蛇毒血清的情况下与管理相关的挑战。

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