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001-es BibID:BIBFORM060289
Első szerző:Krecsák László
Cím:Clinical picture of envenoming with the Meadow Viper (Vipera (Acridophaga) ursinii) / László Krecsák, Gábor Zacher, Tamás Malina
Dátum:2011
ISSN:1556-3650
Megjegyzések:Objective. The vipers in the Vipera (Acridophaga) ursinii complex are small-sized insectivorous snakes found in parts of central andsouthern Europe. Subspecies include Vipera ursinii ursinii, Vipera ursinii moldavica, Vipera ursinii macrops, Vipera ursinii rakosiensis,and Vipera ursinii graeca and are commonly known as the meadow vipers. These are the least known European Vipera from a clinicalpoint of view. Methods. We identified cases of V. ursinii envenomations through three methods, including literature search in PubMed,ISI web of Knowldge, JSTOR, Biological Abstracts, Zoological Record, using the various combination of the following terms: snakebite,envenoming, bite, venom, ursinii, meadow viper, steppe viper (in English, French, Italian, Hungarian, Croatian, Serbian, Romanian),review of paper-based medical case records of hospitals in Hungary (four) and Romania (one) covering the 1970?July 2010 period, andpersonal communications of professional and amateur herpetologists studying V. ursinii and snake-handlers bitten by these snakes.Results. We identified 64 cases from subspecies: V. u. ursinii (14), V. u. moldavica (8), V. u. macrops (5), and V. u. rakosiensis (37).Forty-five bites were collected from the literature, 5 from hospitals, 10 cases were communicated by seven herpetologists and four cases bytwo snake keepers. Bites were mostly asymptomatic. Forty-five envenomings (70%) resulted in mild and moderate local symptoms,involving pain with low-intensity, pruritus, numbness, swelling with or without erythema and/or local hematoma. Bullae (n?3, 5%), mildsuperficial necrosis (n?4, 6%), cellulitis (n?1, 2%), and moderately extended edema (n?8, 13%) of the bitten extremity rarely develop.Massive limb edema was recorded in eight (13%) cases. The most common systemic symptoms were dizziness caused by transienthypotension and tachycardia. Gastrointestinal disorders (i.e. nausea, vomiting) were rare (n?2, 3%) compared to other Vipera, andprobably triggered only by anxiety. Symptomatic and supportive therapy was applied in the relatively severe envenomings and antivenomtherapy in six cases. Complete recovery ranged from 12 h to 2 weeks. Moderate and severe envenomings required significantly longerrecovery. Application of first aid was associated with significantly longer recovery times. Neither the age (i.e. juvenile or adult) of theculprit specimen, nor the anatomical location of the bite determined the severity of symptoms. Conclusion. Professional and amateurherpetologists, and snake keepers are mainly at risk. Most V. ursinii bites do not require first aid or medical intervention, since only localsymptoms develop and resolve spontaneously. The rare hospitalized cases require symptomatic and supportive treatment only. Antivenomtherapy is not indicated.
Tárgyszavak:Természettudományok Biológiai tudományok idegen nyelvű folyóiratközlemény külföldi lapban
Snakebite
Envenoming
Limited swelling
Megjelenés:Clinical Toxicology. - 49 : 1 (2011), p. 13-20. -
További szerzők:Zacher Gábor Malina Tamás (1980-) (biológus)
Internet cím:DOI
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