À propos de trois observations d’envenimations vipérines graves au Maroc

Chani, M.; L’kassimi, H.; Abouzahir, A.; Nazi, M.; Mion, G.

doi:10.1016/j.annfar.2008.02.008

Cited by 20 publications

(5 citation statements)

References 3 publications

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“…In conclusion, we reported an extremely rare case of envenomation following viper bite in France, responsible for a late bilateral pulmonary embolism. Our case is atypical because the patient had normal levels of fibrinogen, aPTT, INR, and platelet counts, whereas in Chani cases 7 and Baghat case 10 patients had DIC-like syndrome with low levels of fibrinogen. However, delay between the bite and happening of pulmonary embolism was similar between our case and all described cases.…”

Section: Resultsmentioning

confidence: 63%

“…Three happened in Morocco, caused by different Moroccan vipers. 6 , 7 In these cases, 7 pulmonary embolism also occurred exactly 1 week after the bite, without associated phlebitis and after a previous subcutaneous hematoma. However, DIC syndrome was described in all 3 cases, with decreased fibrinogen and elevated activated partial thromboplastin time (aPTT) ratio.…”

Section: Resultsmentioning

confidence: 89%

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Bilateral Pulmonary Embolism Following a Viper Envenomation in France

et al. 2016

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Complications following snake bites are not common in France. We report the case of a bilateral pulmonary embolism following a viper envenomation in France.A healthy 72-year-old female presented with a lower limb hematoma following a viper bite. She was admitted at the hospital 2 days later and received low-molecular-weight heparin because of bed rest. Seven days later, she complained of thoracic pain and respiratory failure, and a bilateral pulmonary was diagnosed, without biological sign of neither disseminated intravascular coagulation nor coagulation trouble. Repeated lower limbs Doppler ultrasound were normal.This case is particularly interesting because it is only the 7th reported case of pulmonary embolism following a snake envenomation; moreover, it happened in France where poisonous snakes are very rare.Several hypotheses have been made to explain this late localized coagulopathy: an increased level of unstable fibrin produced by thrombin-like glycoproteins from the venom is one of them.

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Section: Resultsmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 89%

Bilateral Pulmonary Embolism Following a Viper Envenomation in France

et al. 2016

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“…Ces chiffres sous-estiment probablement l'incidence réelle des envenimations ophidiennes au Maroc, du fait de la sous-notification globale des intoxications par les médecins. Dans notre contexte marocain, 98 % des morsures sont dues à des vipères, elles touchent volontiers des sujets masculins jeunes, pendant l'activité agricole en milieu rural, d'avril à septembre, avec un pic en juillet [7]. Cette répartition saisonnière est retrouvée dans notre série : l'incidence est maximale pendant la période allant de juin à septembre (83 % des cas), elle est concomitante avec une activité vipérine plus intense dans cette période de l'année.…”

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Snake bites in children at the Fez University Hospital in Morocco

Berdaï

Labib

Harandou

2013

Médecine Et Santé Tropicales

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Aims. The objective of our study is to describe the epidemiological, clinical, biological, and therapeutic aspects of snake bites in children in northern Morocco. Methods. This retrospective study reviewed files of all children admitted to the pediatric intensive care unit of the Hasssan II University Hospital in Fez from April 2011 through April 2013. It includes all children reported by themselves or their family to have been bitten by a snake and all those with traces of snake fangs. Results. This study included 12 children, with a mean age of 9.6 AE 2.9 years. In each case, admission took place the day the envenomation occurred, a mean of 8.8 AE 5.6 hours after the bite. Locoregional signs and edema were seen in all cases, associated with bruising (58%) and blisters (25%). General events, including gastrointestinal, cardiovascular, neurologic, and hemorrhagic signs, affected 83% of the children. Hemostasis disorders occurred in 91% of patients, including profound thrombocytopenia (mean: 27.7 AE 30.7 G/L. All envenomations were grade 2 or grade 3. Analgesia was administered systematically; a fasciotomy was performed in 25% of cases and transfusion of blood products in 66%. Three children (25%) were intubated and two children died (16%). Conclusion. This series is characterized by the severity of the clinical presentations, with a predominance of locoregional complications and hemostasis disorders corresponding to snake-bite syndrome. We conclude that immunotherapy adapted to the local species must be made available to improve the prognosis of this envenomation.

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“…Bitis, la plus grosse des vipères, mesure de un à deux mètres de long, a une capacité venimeuse considérable (hémorragie, venin extrêmement nécrosant). Echis ocellatus et les espèces voisines (E. leucogaster, E. pyramidum), malgré leur taille réduite (une soixantaine de centimètres), sont responsables de la majorité des décès en Afrique par syndrome hémorragique; la nécrose est plus rare [6]. …”

Section: Discussionunclassified

Envenimation mortelle par morsure de serpent chez une femme enceinte

Shimi¹,

Berdai²,

Bahra³

et al. 2011

Pan Afr Med Jrnl

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En Afrique, la prise en charge des envenimations vipérines demeure un problème majeur de santé publique avec un taux de mortalité qui reste élevé. La survenue d’une envenimation vipérine au cours de la grossesse est un événement rare, et grave du fait des conséquences maternelles et fœtales qui en découlent. Les auteurs rapportent un cas de morsure de serpent au niveau de la face chez une femme enceinte, dont l’évolution a été marquée par l’installation d’un œdème cervico-facial nécessitant une trachéotomie en urgence, et une mort fœtale in utero avec troubles de l’hémostase responsable du décès maternel dans un tableau de choc hémorragique.

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À propos de trois observations d’envenimations vipérines graves au Maroc

Cited by 20 publications

References 3 publications

Bilateral Pulmonary Embolism Following a Viper Envenomation in France

Bilateral Pulmonary Embolism Following a Viper Envenomation in France

Snake bites in children at the Fez University Hospital in Morocco

Envenimation mortelle par morsure de serpent chez une femme enceinte

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