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黄颌蛇咬伤:双色无须魮“假珊瑚”蛇咬伤-临床特点和识别类似蛇种的重要性。

Colubrid snake envenomation: Erythrolamprus bizona "false coral" snakebite - clinical aspects and importance of identifying mimics.

机构信息

Sistema Nacional de Investigación-SENACYT, Panamá; Bella Vista, Manuel E. Batista y Ave. Jose De Fabrega, Panama City, Panama Province, Panama; Infectotrópico, SA, Panamá.

Serpentario Maravillas Tropicales, Valle de Antón, Panamá.

出版信息

Am J Emerg Med. 2024 Nov;85:267.e1-267.e6. doi: 10.1016/j.ajem.2024.09.018. Epub 2024 Sep 12.

Abstract

Colubrids represent a diverse group of snakes historically regarded as harmless. With over 300 genera, the Colubridae family is the largest, encompassing approximately two-thirds of extant snake species. We describe a case of an 18-year-old male who suffered a colubrid snakebite from Erythrolamprus bizona, commonly known as the double-stranded coral snake mimic or false coral snake, which he misidentified as Lampropeltis sp., a fangless colubrid snake. Patient experienced localized erythema and edema, which later spread to the entire left hand along with moderate pain. Laboratory tests revealed leukocytosis and elevated creatine kinase. Symptoms resolved one week later. This case highlights the public health significance of ophidian accidents due to apparently "non-venomous snakes" or low-risk snakes such as the opisthoglyphous colubrid E. bizona. It also underscores the need to correctly identify and differentiate these snakes from other harmless colubrids, particularly double-stranded coral snake mimics in areas of geographic overlap and avoid their manipulation if uncertain of their taxonomic status.

摘要

游蛇科是一个多样化的蛇类群体,历史上被认为是无毒的。游蛇科有超过 300 个属,是最大的蛇科,约占现存蛇类物种的三分之二。我们描述了一个 18 岁男性的病例,他被 Erythrolamprus bizona(双斑锦蛇的拟态或假珊瑚蛇)咬伤,他错误地将其识别为 Lampropeltis sp.(无牙游蛇)。患者出现局部红斑和水肿,随后沿左手整个手掌扩散,并伴有中度疼痛。实验室检查显示白细胞增多和肌酸激酶升高。一周后症状缓解。该病例强调了由于看似“无毒蛇”或低风险蛇(如后沟牙游蛇 E. bizona)引起的蛇咬伤的公共卫生意义。它还强调了需要正确识别和区分这些蛇与其他无害的游蛇,特别是在地理重叠地区的双斑锦蛇拟态,并且如果不确定其分类地位,应避免操作这些蛇。

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