Emergency and Trauma Department Hospital Tengku Ampuan Rahimah, Ministry of Health Malaysia, Selangor, Malaysia.
Emergency and Trauma Department Hospital Banting, Ministry of Health Malaysia, Selangor, Malaysia.
Toxicon. 2024 Oct;249:108086. doi: 10.1016/j.toxicon.2024.108086. Epub 2024 Sep 2.
There is very limited published experience on mangrove pit viper envenomation in the medical literature. This study aims to analyze the clinical characteristics, treatment modalities and outcomes of patients presenting to Selangor middle zone cluster Hospitals in Malaysia with confirmed mangrove pit viper bites.
We conducted a retrospective observational study, reviewing medical records of patients treated for mangrove pit viper bites between July 1, 2020 to June 30, 2023. Data on patient demographics, clinical characteristic, laboratory findings, treatment modalities and clinical outcomes were collected and analyzed.
A total of 25 patients were included in this study. The majority of the patients were male (n = 23, 92%) with the mean age of 38.7 ± 17.6 years. Most frequent anatomical region involved is foot (n = 12, 48%). Common clinical presentation included localized pain (n = 24, 96%), swelling (n = 22, 88%) and fang mark (n = 22, 88%). Systemic symptoms were less common, with 1 patient exhibiting coagulopathy with clinical bleeding at 28 h post bite. Antivenom was administered to 68% (n = 17) of the patients. The majority of the patients (n = 23, 92%) recovered without significant morbidity while 8% (n = 2) of the patients developed skin infection that required antibiotic therapy. No fatalities were reported.
Mangrove pit viper envenomation encountered in these regions predominantly causes local symptoms while systemic symptoms were less common. This study provides a glimpse to the clinical characteristics and management of mangrove pit viper envenomation, coagulopathy may be delayed due to characteristic of the snake venom and patient's preexisting illness. Further research is needed to enhance our understanding of this snakebite envenomation.
医学文献中关于红树林竹叶青蛇咬伤的报道非常有限。本研究旨在分析 2020 年 7 月 1 日至 2023 年 6 月 30 日期间在马来西亚雪兰莪中部集群医院就诊并确诊为红树林竹叶青蛇咬伤的患者的临床特征、治疗方式和结局。
我们进行了一项回顾性观察性研究，回顾分析了 2020 年 7 月 1 日至 2023 年 6 月 30 日期间在马来西亚雪兰莪中部集群医院就诊并确诊为红树林竹叶青蛇咬伤的患者的病历。收集并分析了患者的人口统计学、临床特征、实验室检查结果、治疗方式和临床结局等数据。
本研究共纳入 25 例患者。大多数患者为男性（n=23，92%），平均年龄为 38.7±17.6 岁。最常见的受累解剖部位为足部（n=12，48%）。常见的临床表现包括局部疼痛（n=24，96%）、肿胀（n=22，88%）和牙痕（n=22，88%）。全身症状较少见，1 例患者在咬伤后 28 小时出现凝血功能障碍和临床出血。68%（n=17）的患者接受了抗蛇毒血清治疗。大多数患者（n=23，92%）康复良好，无明显并发症，8%（n=2）的患者发生皮肤感染，需要抗生素治疗。无死亡病例报告。
本研究中，这些地区的红树林竹叶青蛇咬伤主要引起局部症状，全身症状较少见。本研究为红树林竹叶青蛇咬伤的临床特征和治疗提供了初步认识，由于蛇毒和患者原有疾病的特点，凝血功能障碍可能会延迟出现。需要进一步研究以加深我们对这种蛇咬伤中毒的认识。
