Severe disseminated intravascular coagulation in a child envenomated by Echis coloratus and successful treatment with monovalent equine immunoglobulin G antivenom
| Autor: | Liat Lerman, Miguel Glatstein, Uri Valla, Dennis Scolnik, Shirley Friedman, Gary Carbell, Itamar Munchak, Christopher Hoyte |
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| Rok vydání: | 2019 |
| Předmět: |
0106 biological sciences
Male medicine.medical_treatment Antivenom Snake Bites Hemorrhage Viper Venoms Toxicology complex mixtures 01 natural sciences Fasciotomy 03 medical and health sciences medicine Coagulopathy Humans Israel Envenomation Blood Coagulation Disseminated intravascular coagulation 0303 health sciences medicine.diagnostic_test biology business.industry Antivenins 010604 marine biology & hydrobiology 030302 biochemistry & molecular biology Disseminated Intravascular Coagulation medicine.disease biology.organism_classification Echis coloratus Anesthesia Cryoprecipitate Child Preschool business Partial thromboplastin time |
| Zdroj: | Toxicon : official journal of the International Society on Toxinology. 167 |
| ISSN: | 1879-3150 |
| Popis: | Background Echis coloratus (Burton Carpet viper), a highly venomous snake belonging to the family Viperidae, is responsible for a large proportion of the venomous snakebites in Israel and Palestinian Authority. Procoagulant enzymes are present in Echis coloratus venom and significant coagulopathy is typical after envenomation. Here we report a case of envenomation by Echis coloratus that involved severe coagulopathy as the main systemic manifestation with severe bleeding after fasciotomy. Case details A 3-year-old boy was admitted to our pediatric critical care unit after a snakebite to his left hand, 2–3 hours post-bite. Based on the possibility of compartment syndrome, a fasciotomy was performed before administration of antivenom. At our hospital, he had altered prothrombin time (PT) and activated partial thromboplastin time (aPTT), with low fibrinogen levels. The snake responsible for the bite was later identified as a 38-cm long Echis coloratus. Five vials of Israeli monovalent antivenom were subsequently administered with step-wise improvement in hematological abnormalities. Other treatments included massive blood products transfusion (packed RBC, FFP, cryoprecipitate, PLT), inotropes and ventilatory support. After a prolonged hospital course the patient had a positive outcome. |
| Databáze: | OpenAIRE |
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