Neurotoxic envenoming by South American coral snake (Micrurus lemniscatus helleri): case report from eastern Ecuador and review
| Autor: | María L Avila-Aguero, German Suarez, David A. Warrell, David Graham, Stephen R. Manock |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty food.ingredient Time Factors Antivenom Snake Bites Context (language use) food parasitic diseases medicine Animals Humans Micrurus Elapidae Envenomation Coral snake Elapid Venoms biology business.industry Antivenins Public Health Environmental and Occupational Health General Medicine Blood Coagulation Disorders medicine.disease biology.organism_classification Surgery Infectious Diseases Respiratory failure Anesthesia Micrurus lemniscatus Parasitology Neurotoxicity Syndromes Cholinesterase Inhibitors Ecuador business Rhabdomyolysis |
| Zdroj: | Transactions of the Royal Society of Tropical Medicine and Hygiene. 102(11) |
| ISSN: | 1878-3503 |
| Popis: | A man bitten by a large coral snake (Micrurus lemniscatus helleri) in the Amazon basin of Ecuador developed persistent excruciating pain in the bitten arm. On admission to hospital less than 30 min later, he had a polymorphonuclear leucocytosis, thrombocytopenia and mildly prolonged prothrombin time/partial thromboplastin time. Not until 14 h after the bite did he develop the first signs of neurotoxicity. Despite treatment with specific antivenom 50 h after the bite, he required oxygen for respiratory failure 60 h, and 6 h of mechanical ventilation 72 h, after the bite. Over the next 38 h, he required two further intubations and periods of assisted ventilation before being airlifted to a tertiary referral hospital. Complications included bacterial pneumonia, pneumothorax, bronchial obstruction by mucus plugs and mild rhabdomyolysis. He was discharged from hospital 15 days after the bite with persistent limb weakness and urinary incontinence but eventually recovered. The interesting and unusual features of this case (severe local pain, very slow evolution of neurotoxic envenoming, persistent thrombocytopenia and mild coagulopathy) are discussed in the context of what is known of the composition of Micrurus venoms and the small clinical literature on envenoming from their bites. |
| Databáze: | OpenAIRE |
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