A rare complication of viper envenomation: cardiac failure. A case report

Chara, Krzysztof; Baccouche, Najeh; Turki, Olfa; Regaig, K; Chaari, Adel; Bahloul, Mabrouk; Bouaziz, Mounir

doi:10.1684/mst.2016.0636

Cited by 4 publications

(6 citation statements)

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“…Flaccid paralysis and respiratory failure often result from elapid bites. Hypovolemic shock (the loss of >20% blood) leading to heart failure [34,35] alongside acute kidney injury [36] are potential causes of death in viper bites. However, there are some vipers that rely on neurotoxic components, such as the atypical South American rattlesnake ( Crotalus durissus terrificus ) the venom of which contains crotoxin, and Russell’s viper, Daboia russelii , which contains U1-viperitoxin-Dr1a [37].…”

Section: Introductionmentioning

confidence: 99%

The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites

Williams

Layfield

Vallance

et al. 2019

Toxins

100

106

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Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA2 inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE.

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Section: Introductionmentioning

confidence: 99%

The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites

Williams

Layfield

Vallance

et al. 2019

Toxins

100

106

View full text Add to dashboard Cite

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“…This cardiotoxic manifestation of the venom showed sinus arrest and junctional escape rhythm on the ECG. This cardiotoxic manifestation of viper venom was corroborated by Chara, et al [52] in a case of acute myocardial infarction and/or ischaemia and myocarditis in a patient following a viper bite. A plethora of events including acute heart failure with acute pulmonary oedema, a state of cardiogenic shock, accompanied by multi-organ failure, intravascular disseminated coagulation and neurological damage were recognised.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 54%

Compendium of medically important snakes, venom activity and clinical presentations in Ghana

et al. 2023

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Background Snake bite envenoming (SBE) is one neglected tropical disease that has not received the needed attention. The sequelae of burdensome disability and mortality impact the socioeconomic life of communities adversely with little documentation of SBE in health facility records in Ghana. This study details SBE and snake distribution, habits/habitats, type of venom expressed and clinical manifestations. Methodology We conducted a structured thematic desk review of peer reviewed papers, books and reports from repositories including PubMed, WHO and WCH using bibliographic software EndNote and search engine Google Scholar with the following key words; snakes, medical importance, snake bites, venom and venom type, envenomation, symptoms and signs, vaccines, venom expenditure, strike behaviour and venom-metering + Ghana, West Africa, Africa, World. We also reviewed data from the District Health Information Management System (DHIMS) of the Ghana Health Service (GHS). Outcome variables were organized as follows: common name (s), species, habitat/habit, species-specific toxin, clinical manifestation, antivenom availability, WHO category. Findings Snake bites and SBE were grouped by the activity of the expressed venom into neurotoxic, cardiotoxic, haemorrhagic, cytotoxic, myotoxic, nephrotoxic and procoagulants. Neurotoxic snake bites were largely due to elapids. Expressed venoms with cardiotoxic, haemorrhagic, nephrotoxic and procoagulant activities principally belonged to the family Viperidae. Snakes with venoms showing myotoxic activity were largely alien to Ghana and the West African sub-region. Venoms showing cytotoxic activity are expressed by a wide range of snakes though more prevalent among the Viperidae family. Snakes with neurotoxic and haemorrhagic venom activities are prevalent across all the agro-ecological zones in Ghana. Conclusion/Significance Understanding the characteristics of snakes and their venoms is useful in the management of SBE. The distribution of snakes by their expressed venoms across the agro-ecological zones is also instructive to species identification and diagnosis of SBE.

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“…Miotoxicidad: Algunas especies de Bothrops pueden tener efectos miotóxicos, lo que causa daño directo a las células musculares. La liberación de mioglobina y otros productos celulares dañados pueden contribuir a la insu ciencia renal aguda, agravando aún más la (7) condición hemodinámica del paciente .…”

Section: Pág 183unclassified

“…La atención médica inmediata es crucial en las m o r d e d u r a s d e s e r p i e n t e s v e n e n o s a s p a r a contrarrestar los efectos del veneno y prevenir complicaciones graves como el choque cardiogénico. Dependiendo de las manifestaciones clínicas del paciente, el tratamiento puede incluir la administración de antídoto, medidas de apoyo hemodinámico y otros (7,8) enfoques terapéuticos especí cos . La mordedura de serpiente venenosa es una enfermedad tropical (1,2) desatendida de gran interés en salud pública , y se reportan 5.4 millones de casos anualmente.…”

Section: Pág 183unclassified

Heart failure secondary to a snake bite. The intensivist's vision: case report

Restrepo Bastidas,

Aguirre Flórez,

Hoyos Muñoz

et al. 2024

RFMH

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Background: Ophidic accident is a neglected disease that affects tropical countries. Latin America is the second region after Africa, with the most cases worldwide. Local lesions accompany its clinical course up to systemic affectations such as renal, hematological, and neurological lesions. Cardiac complications are rare, especially in patients who do not have cardiovascular risk factors. There are reports of acute myocardial infarction, but there is little information about heart failure due to Bothrops spp. Case report: We present the case of a 25-year-old man without cardiovascular risk factors who was admitted to the intensive care unit and developed heart failure with cardiogenic shock and multi-organ failure secondary to a snake bite. Conclusions: Although the characteristic clinical course of a bothropic ophidian accident and its systemic manifestations are mainly related to coagulation abnormalities, there are cardiovascular complications within its clinical presentation that, although rare, if not detected promptly and not adequately managed, are associated with high morbidity and mortality.

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A rare complication of viper envenomation: cardiac failure. A case report

Cited by 4 publications

References 0 publications

The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites

The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites

Compendium of medically important snakes, venom activity and clinical presentations in Ghana

Heart failure secondary to a snake bite. The intensivist's vision: case report

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