From the Research
Envenomation by Viperidae snakes presents with distinctive clinical features that develop progressively after a bite, including local pain, swelling, and ecchymosis, as well as systemic manifestations such as coagulopathy, thrombocytopenia, and spontaneous bleeding, which can be effectively managed with prompt administration of antivenom and supportive care, as demonstrated in a recent study 1.
Clinical Features
The clinical features of envenomation by Viperidae snakes can be classified into four clinical types, including the cobra syndrome, viper syndrome, disturbance of blood circulating functions, and disturbance of other live functions, as described in a study published in the Bulletin de la Societe de pathologie exotique 2. The viper syndrome is characterized by bleeding and inflammation, which can be due to a viper, pit viper, or Elapids in Australia.
Systemic Manifestations
Systemic manifestations of envenomation by Viperidae snakes include coagulopathy with prolonged clotting times, thrombocytopenia, and spontaneous bleeding from gums, injection sites, or wounds due to the venom's hemotoxic components that disrupt normal clotting mechanisms, as reported in a study published in Toxicology 3. Patients may also develop hypotension and shock from fluid extravasation and bleeding.
Treatment
Treatment of envenomation by Viperidae snakes requires prompt administration of appropriate antivenom specific to the regional Viperidae species, along with supportive care including fluid resuscitation, blood product replacement, wound care, and monitoring for compartment syndrome, as recommended in a study published in Clinical toxicology (Philadelphia, Pa.) 1. Early treatment is crucial as venom effects progress rapidly and can lead to permanent tissue damage, organ failure, or death if not addressed promptly.
Antivenom Administration
Antivenom should be administered as soon as possible for patients meeting clinical criteria, and repeated dosing may be necessary due to persisting or worsening local effects, as demonstrated in a study published in Clinical toxicology (Philadelphia, Pa.) 1. Close collaboration with expert consultant advice can help optimize antivenom timing and ensure repeated dosing is given appropriately.
Key Points
- Envenomation by Viperidae snakes presents with distinctive clinical features that develop progressively after a bite.
- Systemic manifestations include coagulopathy, thrombocytopenia, and spontaneous bleeding.
- Treatment requires prompt administration of antivenom and supportive care.
- Early treatment is crucial to prevent permanent tissue damage, organ failure, or death.
- Repeated dosing of antivenom may be necessary due to persisting or worsening local effects.