Clinical features of viper bites in 72 Thai children.

A study of snake bites in 72 children admitted to Department of Paediatrics Chulalongkorn Hospital, during January 1972 to December 1977, was investigated in depth. In 29 cases, snakes were definitely identified as green pit viper. Nature of the bite was demonstrated. Their two main clinical manifestations were local swelling and bleeding diathesis. The former was graded I to IV in increasing severity. The latter consisted of ecchymosis, haematoma, haematemesis, haematuria, bleeding gums, epistaxis and bloody stool. Each of these two clinical signs seemed to be caused by a different component of the venom as they did not always manifest in association. Swelling, though not a specific sign, was however generally the sign that heralded the envenomization. 88.1% and 94.5% of systemic bleeding episodes occurred respectively within 24 and 48 hours after the bite. Only 6 episodes, 5.5%, occurred beyond 48 hours.