Echis coloratus envenomation in children: a retrospective case series

Antivenoms for local effects of snake envenoming 

“…These studies have investigated or commented on the effects of antivenom on local effects caused by pit vipers such including Crotalus species (Caiaffa et al, 1994;Grace and Omer, 1980;Heise et al, 2018;Ruha et al, 2002), Bothrops species (Caiaffa et al, 1994), Bothrops alternatus (Bauab 1994), Crotalus helleri (Bush et al, 2002), Agkistrodon contortrix (Lavonas et al, 2004); Protobothrops mucrosquamatus and Viridovipera stejnegeri (Lin et al, 2022), Trimeresurus albolabris and T. macrops (Chotenimitkhun and Rojnuckarin, 2008); and Hypnale hypnale ( Ariaratnam et al, 2008); true vipers such as Echis carinatus (Warrell et al, 1977), Echis occellatus (Chippauxl et al, 1998;Monzavi et al, 2019), Echis coloratus (Glatstein et al, 2022), Daboia palaestinae (Bentur, 1997;Pivko-Levy et al, 2017), Vipera berus (Karlson-Stiber & Persson, 1994), V. aspis (Boels et al, 2012), Vipera ammodytes (Brvar et al, 2017), Bitis arietans (Warrell, 1975), and Bitis gabonica (Marsh et al, 2007), Asiatic cobras such as Naja polyoccelata (formerly Sri Lankan Naja naja) (Kularatne et al, 2009;Phillips et al, 1988), Naja kaouthia (Faiz et al, 2017;Pochanugool et al, 1997), and Naja atra (Mao et al, 2018;Wong et al, 2010), African cobras such as Naja nigricollis , Naja mossambica (Tilbury, 1982) and Atractaspis dahomeyensis and A. microlepidota and in Australia, death adders (Acanthophis sp) (Isbister et al, 2010). The case reports, due to their high reporting bias, are not discussed here.…”

“…These observational studies either suggested (1) no effect of antivenom or failure of antivenom to prevent local effects (Chotenimitkhun and Rojnuckarin, 2008;Heise et al, 2018;Kularatne et al, 2009;Phillips et al, 1988;Warrell et al, 1977;, (2) antivenom halting the progression of local effects (Lavonas et al, 2004;Ruha et al, 2002), (3) early antivenom preventing the occurrence of severe local effects including necrosis (Warrell, 1975), (4) early antivenom leading to faster functional improvement (Boels et al, 2012), (5) antivenom accelerating the resolution of local effects (Brvar et al, 2017;Glatstein et al, 2022) or (6) no conclusion (Bauab 1994;Bush et al, 2002;Caiaffa et al, 1994;Lin et al, 2022;Mao et al, 2018;Pochanugool et al, 1997).…”