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1.
Longbottom J et al., 2018. Vulnerability to snakebite envenoming: A global mapping of hotspots. Lancet 392: 673–684.
-
2.
Minghui R, Malecela MN, Cooke E, Abela-Ridder B, 2019. WHO’s snakebite envenoming strategy for prevention and control. Lancet Glob Health 7: e837–e838.
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3.
Alencar LRV, Quental TB, Grazziotin FG, Alfaro ML, Martins M, Venzon M, Zaher H, 2016. Diversification in vipers: Phylogenetic relationships, time of divergence and shifts in speciation rates. Mol Phylogenet Evol 105: 50–62.
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4.
Babenko VV et al., 2020. Novel bradykinin-potentiating peptides and three-finger toxins from viper venom: Combined NGS venom gland transcriptomics and quantitative venom proteomics of the Azemiops feae viper. Biomedicines 8: 249.
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5.
Tsai IH, Wang YM, Lin SW, Huang KF, 2021. Structural and bioinformatic analyses of Azemiops venom serine proteases reveal close phylogeographic relationships to pitvipers from eastern China and the New World. Toxicon 198: 93–101.
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6.
Utkin YN et al., 2012. Azemiopsin from Azemiops feae viper venom, a novel polypeptide ligand of nicotinic acetylcholine receptor. J Biol Chem 287: 27079–27086.
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7.
Valenta J, Stach Z, Stourac P, Kadanka Z, Michalek P, 2015. Neurological symptoms following the Fea’s viper (Azemiops feae) bite. Clin Toxicol (Phila) 53: 1150–1151.
-
8.
Di Nicola MR, Pontara A, Kass GEN, Kramer NI, Avella I, Pampena R, Mercuri SR, Dorne JLCM, Paolino G, 2021. Vipers of major clinical relevance in Europe: Taxonomy, venom composition, toxicology and clinical management of human bites. Toxicology 453: 152724.
-
9.
Jadon RS, Sood R, Bauddh NK, Ray A, Soneja M, Agarwal P, Wig N, 2021. Ambispective study of clinical picture, management practices and outcome of snake bite patients at tertiary care centre in Northern India. J Family Med Prim Care 10: 933–940.
-
10.
Paul V, Pratibha S, Prahlad KA, Earali J, Francis S, Lewis F, 2004. High-dose anti-snake venom versus low-dose anti-snake venom in the treatment of poisonous snake bites—A critical study. J Assoc Physicians India 52: 14–17.
-
11.
World Health Organization, 2010. Guidelines for the Management of Snake-Bites. Geneva, Switzerland: WHO.
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12.
Ryan NM, Kearney RT, Brown SG, Isbister GK, 2016. Incidence of serum sickness after the administration of Australian snake antivenom (ASP-22). Clin Toxicol (Phila) 54: 27–33.
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13.
Huang TI, Hsieh CL, 2020. Effect of traditional Chinese medicine on long-term outcomes of snakebite in Taiwan. Toxins (Basel) 12: 132.
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14.
Luo J, Guo M, Xie K, Han TL, Ai S, 2024. Metabolomic analysis of Agkistrodon haly venom poisoning mouse treatment by Jidesheng snake pill based on GC-MS. Front Pharmacol 15: 1419609.
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15.
Chen Q, Wang W, Li Q, Bai Y, Zou X, Wu Y, 2014. Effect of externally applied Jidesheng anti-venom on skin and soft-tissue necrosis after Chinese cobra bite: A retrospective study. J Tradit Chin Med 34: 150–154.
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Management of an Uncommon Snakebite Envenomation (Azemiops kharini)
Shuan-Zhu Guo
Shuan-Zhu Guo
The First Clinical Medical College of Guangdong Medical University, Zhanjiang, China;
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Shi-Ming Zhan
Shi-Ming Zhan
The First Clinical Medical College of Guangdong Medical University, Zhanjiang, China;
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Shuo-Feng Zhuang
Shuo-Feng Zhuang
The First Clinical Medical College of Guangdong Medical University, Zhanjiang, China;
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Jin Chen
Jin Chen
The First Clinical Medical College of Guangdong Medical University, Zhanjiang, China;
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Tian-Xing Li
li27538945@126.com
Tian-Xing Li
The First Clinical Medical College of Guangdong Medical University, Zhanjiang, China;
Yangjiang Hospital Affiliated to Guangdong Medical University, Yangjiang, China
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Yangjiang Hospital Affiliated to Guangdong Medical University, Yangjiang, China
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ABSTRACT.
Envenomation and death resulting from snakebites represent a significant public health problem worldwide, posing a substantial threat to human lives. Azemiops kharini (white-headed Burmese viper) venom is a mixed toxin that usually causes swelling and pain, paresthesias, blood clotting disorders, cardiopulmonary arrest, and even multiple organ dysfunction syndrome. The patient exhibited symptoms of envenomation after an A. kharini snakebite, including decreased fibrinogen levels and finger stiffness. Management entailed the administration of a combination therapy consisting of multiple monovalent antivenoms along with Jidesheng snake pill. Finally, a favorable outcome was observed. We present a case of A. kharini snakebite envenomation managed at our medical facility for the benefit of fellow health care providers.
Author Notes
Disclosures: Ethics approval to publish a case report is not mandatory at our institution. However, we took all precautions to protect the patient’s rights by phone, and informed consent was obtained from the patient to publish clinical data and the photograph of the snake. The material is original and has not been published elsewhere.
Current contact information: Shuan-Zhu Guo, Shi-Ming Zhan, Shuo-Feng Zhuang, Jin Chen, and Tian-Xing Li, Yangjiang Hospital Affiliated to Guangdong Medical University, Yangjiang, Guangdong, China, E-mails: 15531411987@163.com, zhanshiming74@163.com, 13078218302@163.com, 15917068490@163.com, and li27538945@126.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Longbottom J et al., 2018. Vulnerability to snakebite envenoming: A global mapping of hotspots. Lancet 392: 673–684.
-
2.
Minghui R, Malecela MN, Cooke E, Abela-Ridder B, 2019. WHO’s snakebite envenoming strategy for prevention and control. Lancet Glob Health 7: e837–e838.
-
3.
Alencar LRV, Quental TB, Grazziotin FG, Alfaro ML, Martins M, Venzon M, Zaher H, 2016. Diversification in vipers: Phylogenetic relationships, time of divergence and shifts in speciation rates. Mol Phylogenet Evol 105: 50–62.
-
4.
Babenko VV et al., 2020. Novel bradykinin-potentiating peptides and three-finger toxins from viper venom: Combined NGS venom gland transcriptomics and quantitative venom proteomics of the Azemiops feae viper. Biomedicines 8: 249.
-
5.
Tsai IH, Wang YM, Lin SW, Huang KF, 2021. Structural and bioinformatic analyses of Azemiops venom serine proteases reveal close phylogeographic relationships to pitvipers from eastern China and the New World. Toxicon 198: 93–101.
-
6.
Utkin YN et al., 2012. Azemiopsin from Azemiops feae viper venom, a novel polypeptide ligand of nicotinic acetylcholine receptor. J Biol Chem 287: 27079–27086.
-
7.
Valenta J, Stach Z, Stourac P, Kadanka Z, Michalek P, 2015. Neurological symptoms following the Fea’s viper (Azemiops feae) bite. Clin Toxicol (Phila) 53: 1150–1151.
-
8.
Di Nicola MR, Pontara A, Kass GEN, Kramer NI, Avella I, Pampena R, Mercuri SR, Dorne JLCM, Paolino G, 2021. Vipers of major clinical relevance in Europe: Taxonomy, venom composition, toxicology and clinical management of human bites. Toxicology 453: 152724.
-
9.
Jadon RS, Sood R, Bauddh NK, Ray A, Soneja M, Agarwal P, Wig N, 2021. Ambispective study of clinical picture, management practices and outcome of snake bite patients at tertiary care centre in Northern India. J Family Med Prim Care 10: 933–940.
-
10.
Paul V, Pratibha S, Prahlad KA, Earali J, Francis S, Lewis F, 2004. High-dose anti-snake venom versus low-dose anti-snake venom in the treatment of poisonous snake bites—A critical study. J Assoc Physicians India 52: 14–17.
-
11.
World Health Organization, 2010. Guidelines for the Management of Snake-Bites. Geneva, Switzerland: WHO.
-
12.
Ryan NM, Kearney RT, Brown SG, Isbister GK, 2016. Incidence of serum sickness after the administration of Australian snake antivenom (ASP-22). Clin Toxicol (Phila) 54: 27–33.
-
13.
Huang TI, Hsieh CL, 2020. Effect of traditional Chinese medicine on long-term outcomes of snakebite in Taiwan. Toxins (Basel) 12: 132.
-
14.
Luo J, Guo M, Xie K, Han TL, Ai S, 2024. Metabolomic analysis of Agkistrodon haly venom poisoning mouse treatment by Jidesheng snake pill based on GC-MS. Front Pharmacol 15: 1419609.
-
15.
Chen Q, Wang W, Li Q, Bai Y, Zou X, Wu Y, 2014. Effect of externally applied Jidesheng anti-venom on skin and soft-tissue necrosis after Chinese cobra bite: A retrospective study. J Tradit Chin Med 34: 150–154.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 10296 | 10296 | 2971 |
| Full Text Views | 31 | 31 | 12 |
| PDF Downloads | 23 | 23 | 8 |