Lalloo D, Trevett A, Black J, Mapao J, Naraqi S, Owens D, Hutton R, Theakston R D, Warrell D A
Department of Clinical Sciences, University of Papua New Guinea, Port Moresby.
Toxicon. 1994 Aug;32(8):927-36. doi: 10.1016/0041-0101(94)90371-9.
Among 335 patients presenting with snakebites in Central Province, Papua New Guinea, nine were proved by enzyme immunoassay to have been bitten by Papuan black snakes (Pseudechis papuanus). Seven showed clinical evidence of envenoming. Early symptoms included vomiting and tender local lymph nodes. Five patients had neurotoxic signs and one required mechanical ventilation. Spontaneous systemic bleeding occurred in two patients. Coagulation studies in four patients showed thrombocytopenia, prolongation of prothrombin time, mild defibrination and depletion of other clotting factors with elevated fibrin(ogen) degradation products and other evidence of fibrinolysis. One patient developed mild renal dysfunction. There was no evidence of intravascular haemolysis or rhabdomyolysis. These clinical observations, which do not distinguish victims of P. papuanus from those of taipans (Oxyuranus scutellatus canni), suggest that the venom contains neurotoxic, haemorrhagic and mild procoagulant activities. Only two other cases of proven envenoming by this species have been reported. There appears to have been a decline in the abundance of this species, and hence its medical importance, over the last 25 years.
在巴布亚新几内亚中部省份出现的335例蛇咬伤患者中，酶免疫测定证实有9例被巴布亚黑蛇（Pseudechis papuanus）咬伤。7例有中毒的临床证据。早期症状包括呕吐和局部淋巴结压痛。5例患者有神经毒性体征，1例需要机械通气。2例患者出现自发性全身出血。4例患者的凝血研究显示血小板减少、凝血酶原时间延长、轻度纤维蛋白溶解和其他凝血因子消耗，纤维蛋白（原）降解产物升高及其他纤维蛋白溶解证据。1例患者出现轻度肾功能不全。没有血管内溶血或横纹肌溶解的证据。这些临床观察结果无法区分巴布亚黑蛇咬伤的受害者和太攀蛇（Oxyuranus scutellatus canni）咬伤的受害者，提示该毒液含有神经毒性、出血性和轻度促凝血活性。此前仅报道过另外2例经证实被该物种咬伤中毒的病例。在过去25年里，该物种的数量似乎有所下降，因此其医学重要性也有所降低。
