Severe coagulopathy and transient hypertension following a Rhabdophis subminiatus bite: a case report

Nelwan, Erni Juwita; Adiwinata, Randy; Handayani, Siti Ragil; Rinaldi, Ikhwan

doi:10.1590/0037-8682-0314-2015

Cited by 9 publications

(5 citation statements)

References 9 publications

(9 reference statements)

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“…However, the relationship between the colubrid venom and the elevated blood pressure observed in the patient is unclear. There are few reports about transient hypertension in other colubrid envenomation 17 , nevertheless, blood pressure and renal function monitoring in these patients is recommended.…”

Section: Discussionmentioning

confidence: 99%

A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia

et al. 2020

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Envenomations by colubrid snakes in Colombia are poorly known, consequently, the clinical relevance of these species in snakebite accidents has been historically underestimated. Herein, we report the first case of envenomation by opisthoglyphous snakes in Colombia occurred under fieldwork conditions at the municipality of Distracción, in the department of La Guajira. A female biologist was bitten on the index finger knuckle of her right hand when she tried to handle a false fer-de-lance snake (Leptodeira annulata). Ten minutes after the snakebite, the patient started to have symptoms of mild local envenomation such as edema, itching, and pain in the wound. After 40 minutes, the edema reached its maximum extension covering the dorsal surface of the right hand and causing complete loss of mobility. The clinical treatment focused on pain and swelling control. No laboratory tests were performed. The patient showed good progress with the total regression of the edema 120 hours after the snake-bite accident and complete recovery of the movement of the limb in one week. Venomous bites of “non-venomous snakes” (opisthoglyphous colubrid snakes) must be considered as a significant public health problem because patients lose their work capability during hours or even days and they are forced to seek medical assistance to treat the envenomation manifestations.

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Section: Discussionmentioning

confidence: 99%

A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia

et al. 2020

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“…Interestingly, bufadienolides are derived mainly from feeding on toads (Mohammadi & Hill, 2012). The bites of colubrid snakes can lead to severe envenomation, resulting in severe coagulopathy and transient hypertension (Nelwan, Adiwinata, Handayani, & Rinaldi, 2016). Moreover, the symptoms of such snake bites might be delayed for hours or days after the initial bite (Nelwan et al, 2016;Smeets, Melman, Hoffmann, & Mulder, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…The bites of colubrid snakes can lead to severe envenomation, resulting in severe coagulopathy and transient hypertension (Nelwan, Adiwinata, Handayani, & Rinaldi, 2016). Moreover, the symptoms of such snake bites might be delayed for hours or days after the initial bite (Nelwan et al, 2016;Smeets, Melman, Hoffmann, & Mulder, 2010). The diet composition has been determined to have an impact on the host's gut microbiota (Kopečný, Mrázek, & Killer, 2010).…”

Section: Introductionmentioning

confidence: 99%

Characterizing the microbiota in gastrointestinal tract segments of Rhabdophis subminiatus: Dynamic changes and functional predictions

et al. 2019

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The gut microbiota helps the host to absorb nutrients and generate immune responses that can affect host behavior, development, reproduction, and overall health. However, in most of the previous studies, microbiota was sampled mainly using feces and intestinal contents from mammals but not from wild reptiles. Here, we described the bacterial profile from five different gastrointestinal tract (GIT) segments (esophagus, stomach, small intestine, large intestine, and cloaca) of three wild Rhabdophis subminiatus using 16S rRNA V4 hypervariable amplicon sequencing. Forty‐seven bacterial phyla were found in the entire GIT, of which Proteobacteria, Firmicutes, and Bacteroidetes were predominant. The results showed a significant difference in microbial diversity between the upper GIT segments (esophagus and stomach) and lower GIT segments (large intestine and cloaca). An obvious dynamic distribution of Fusobacteria and Bacteroidetes was observed, which mainly existed in the lower GIT segments. Conversely, the distribution of Tenericutes was mainly observed in the upper GIT. We also predicted the microbial functions in the different GIT segments, which showed that microbiota in each segments played an important role in higher membrane transport and carbohydrate and amino acid metabolism. Microbes in the small intestine were also mainly involved in disease‐related systems, while in the large intestine, they were associated with membrane transport and carbohydrate metabolism. This is the first study to investigate the distribution of the gut microbiota and to predict the microbial function in R. subminiatus . The composition of the gut microbiota certainly reflects the diet and the living environment of the host. Furthermore, these findings provide vital evidence for the diagnosis and treatment of gut diseases in snakes and offer a direction for a model of energy budget research.

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“…This study highlighted hypertension as an episodic event without being persistent in the rest of the hospitalization. Indeed, Viperidae and Elapidae venom have cardiotoxic effects that can induce autonomic deregulation and catecholamine release, potentially leading to transient hypertension [17].…”

Section: Discussionmentioning

confidence: 99%

Snake envenomation during pregnancy

Martinez¹,

Osborne²

2019

Clin J Obstet Gynaecol

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Background: We report our experience with management and treatment of pregnant women who were admitted at our institution for snake envenomation. Methods: We reviewed the charts and recorded the management, treatment, and outcome of 51 pregnant women admitted to our high-risk obstetric service with a diagnosis of snakebite. Results: One patient experienced spontaneous abortion, 2 had intrauterine fetal death due to placental abruption, 2 delivered malformed babies, 1 had premature birth of twins with low birthweight. There were no maternal deaths. Conclusion: Snake-venom poisoning in pregnancy is a complex medical emergency that involves complications at the site of the bite and may also involve dysfunction of multiple organ systems in both mother and fetus.

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Severe coagulopathy and transient hypertension following a Rhabdophis subminiatus bite: a case report

Cited by 9 publications

References 9 publications

A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia

A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia

Characterizing the microbiota in gastrointestinal tract segments of Rhabdophis subminiatus: Dynamic changes and functional predictions

Snake envenomation during pregnancy

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