Envenoming by Crotalid Snake Chinese Moccasin Agkistrodon Acutus Bite – A Case Report

Abstract

Although the bites caused by snakes from former Agkistrodon family in the areas of occurrence are not rare and even have certain epidemiologic importance, in case of envenoming by Deinagkistrodon acutus the clinical studies and case reports are very sporadic. This case report describes the envenoming of a private snake breeder bitten by young Chinese moccasin Deinagkistrodon acutus to the thumb of his left hand. He sought for a medical help immediately after snakebite. Patient presented with a local oedema on the affected limb, extending up to the half of the forearm. Laboratory examinations showed serious haemostatic disturbance with defibrination syndrome, immeasurably prolonged clotting times and extreme elevation of D-dimers. No other obvious clinical symptoms were present. Fibrinogen and fresh frozen plasma were administered because the antivenom was not available immediately. The specific antivenom was urgently imported 22 hours after the bite and administered at a dose of two vials three times until laboratory haemocoagulation parameters returned back to physiological values.

Unexpected death in a young man associated with a unilateral swollen leg: Pathological and toxicological findings in a fatal snakebite from Deinagkistrodon acutus (Chinese moccasin)

“…We reviewed the reported case of D . acutus envenomation in Table 1 [4,12‐24]. 82.29% (302/367) of these cases showed abnormalities in platelet counts.…”

“…Deinagkistrodon acutus ( D. acutus ) belongs to the Viperidae family, Crotalinae subfamily and Deinagkistrodon genus (containing only D. acutus ), with widespread distribution throughout the south‐eastern parts of China, northern Vietnam, and Laos [4]. The mortality rate of D. acutus envenomation remains high in China, at approximately 24% [5].…”

Deinagkistrodon acutus envenomation: a report of three cases

“…In contrast, severe coagulopathy and thrombocytopenia are the main laboratory findings of D. acutus envenomation in addition to serious wound complications and systemic bleeding [11–13]. Valenta et al [15] reported a victim of D. acutus bite who developed incoagulable blood between 1.5 and 7 h post-bite. Hung et al [13] reported the case of a man with persistent thrombocytopenia 44 h after envenomation; his platelet level was normal 30 min post-bite.…”

“…In case 1, thrombocytopenia did not show improvement after antivenom therapy, which was probably attributable to uncontrolled infection. Nevertheless, Valenta et al [15] reported a single case of D. acutus envenomation who manifested severe coagulopathy in the absence of thrombocytopenia. Therefore, the exact mechanism of thrombocytopenia in D. acutus snakebite remains unclear.…”

Purification and Characterization of a Novel Antiplatelet Peptide from Deinagkistrodon acutus Venom

“…Animal venoms are considered as one of the most important sources for drug development [ 7 ]. D. acutus (Chinese moccasin or five-pace snake) is considered as the monovalent genus Deiagkistrodon previously classified into one genus Agkistrodon , which lives mainly in southeast China, North Vietnam, Laos, and Taiwan [ 8 ]. D. acutus envenomation causes hemocoagulation disorder, which causes the symptoms of hemorrhage and microthrombi formation.…”