Md. Asaduzzaman , Sazeda Akter , Jafrin Sultana , Nayem Hasan , Zarin Tasrin Haque Tasin , Sadia Satara Zaman , Soumitra Roy , M.M. Jahangir Alam , Fazle Rabbi Chowdhury
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引用次数: 0
Abstract
Background
The green pit viper (Trimeresurus gramineus) is a venomous snake commonly encountered in South Asia, particularly in Bangladesh, and responsible for many snakebite incidents. Management of its envenoming is challenging due to the lack of a specific antivenom, requiring symptomatic and supportive care to address complications. The following case report represents the complexities in managing such envenomation with associated renal and venous thrombotic complications.
Case presentation
A 35-year-old female was admitted with left lower-limb swelling and ecchymosis following a snakebite. She was transferred from a primary-level hospital with acute kidney injury (serum creatinine 4.0 mg/dL) and venom-induced consumption coagulopathy (VICC) (high levels of d-dimer (15 mg/L), prothrombin time (28 seconds) and activated partial thromboplastin time (>120 sec). Duplex ultrasound confirmed presence of femoral vein thrombosis. The patient was treated with fresh frozen plasma along with other supportive measures. His renal function improved, with creatinine levels normalizing in days.
Conclusion
The management of green pit viper envenomation requires close monitoring of coagulation parameters and renal function, along with supportive care. The occurrence of unusual complications, such as deep vein thrombosis, necessitates a conservative and individualized approach to treatment. Further research is needed to better understand the pathophysiology and improve the therapeutic strategies for managing the sequelae of such envenomations.
期刊介绍：
Toxicon has an open access mirror Toxicon: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. An introductory offer Toxicon: X - full waiver of the Open Access fee.
Toxicon''s "aims and scope" are to publish:
-articles containing the results of original research on problems related to toxins derived from animals, plants and microorganisms
-papers on novel findings related to the chemical, pharmacological, toxicological, and immunological properties of natural toxins
-molecular biological studies of toxins and other genes from poisonous and venomous organisms that advance understanding of the role or function of toxins
-clinical observations on poisoning and envenoming where a new therapeutic principle has been proposed or a decidedly superior clinical result has been obtained.
-material on the use of toxins as tools in studying biological processes and material on subjects related to venom and antivenom problems.
-articles on the translational application of toxins, for example as drugs and insecticides
-epidemiological studies on envenoming or poisoning, so long as they highlight a previously unrecognised medical problem or provide insight into the prevention or medical treatment of envenoming or poisoning. Retrospective surveys of hospital records, especially those lacking species identification, will not be considered for publication. Properly designed prospective community-based surveys are strongly encouraged.
-articles describing well-known activities of venoms, such as antibacterial, anticancer, and analgesic activities of arachnid venoms, without any attempt to define the mechanism of action or purify the active component, will not be considered for publication in Toxicon.
-review articles on problems related to toxinology.
To encourage the exchange of ideas, sections of the journal may be devoted to Short Communications, Letters to the Editor and activities of the affiliated societies.
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