PRAGUE MEDICAL REPORT
PRAGUE MEDICAL REPORT
Prague Medical Report je víceoborový biomedicínský časopis publikující původní recenzované vědecké články, přehledové a případové studie a krátké zprávy v angličtině. Časopis založený v roce 1885 jako Sborník lékařský vychází čtyřikrát ročně.

PRAGUE MEDICAL REPORT, Vol 117 No 1 (2016), 61–67

Snakebite Envenoming by Sochurek’s Saw-scaled Viper Echis Carinatus Sochureki

Jiří Valenta, Zdeněk Stach, Pavel Michálek

DOI: https://doi.org/10.14712/23362936.2016.6
zveřejněno: 21. 03. 2016

Abstract

A snake breeder, 47-years-old man, was bitten by the saw-scaled viper (Echis carinatus sochureki). After admission to Toxinology Centre, within 1.5 h, laboratory evaluation showed clotting times prolonged to non-measurable values, afibrinogenaemia, significantly elevated D-dimers, haemolysis and myoglobin elevation. Currently unavailable antivenom was urgently imported and administered within 10 hours. In 24 hours, oligoanuric acute kidney injury (AKI) and mild acute respiratory distress syndrome (ARDS) developed. Despite administration of 10 vials of urgently imported Polyvalent Snake Antivenom Saudi Arabia, the venom-induced consumption coagulopathy (VICC) and AKI persisted. Another ten vials of antivenom were imported from abroad. VICC slowly subsided during the antivenom treatment and disappeared after administration of total 20 vials during 5 day period. No signs of haemorrhage were present during treatment. After resolving VICC, patient was transferred to Department of Nephrology for persisting AKI and requirement for haemodialysis. AKI completely resolved after 20 days. Despite rather timed administration of appropriate antivenom, VICC and AKI developed and the quantity of 20 vials was needed to cease acute symptoms of systemic envenoming. The course illustrates low immunogenicity of the venom haemocoagulation components and thus higher requirements of the antivenom in similar cases.

klíčová slova: Snakebite; Saw-scaled viper; Echis pyramidum sochureki; Coagulopathy; Renal failure; Antivenom

167 x 240 mm
vychází: 4 x ročně
cena tištěného čísla: 450 Kč
ISSN: 1214-6994
E-ISSN: 2336-2936

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