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Vipera berus bites in the Region of Southwest Poland--a clinical analysis of 26 cases.
Wilderness Environ Med. 2010 Jun; 21(2):114-9.WE

Abstract

OBJECTIVE

Vipera berus is the only naturally occurring venomous snake in Poland. Its venom is primarily vasculotoxic and evokes both local and systemic findings. The aim of the study was to review a series of clinical cases of V berus bites occurring in southwest Poland.

METHODS

The charts of 26 patients (age range, 16-66 years; mean, 42 years) hospitalized with V berus bites were retrospectively analyzed using a data collection tool. Demographic and clinical data were extracted.

RESULTS

The most common local findings of envenomation were edema of the bitten limb with associated extravasations observed in 24 (92.3%) patients, but in only 1 (3.8%) case did the edema spread to the trunk. In 22 (84.6%) cases edema disappeared within 2 weeks after the bite. Systemic disturbances observed in the patients were: shock (1 case), mild transient hypotension (1 case), prolonged hypotension (3 cases), bronchospasm and laryngeal edema (1 case), diarrhea (1 case), transient supraventricular arrhythmias (2 cases), neutrophilic hyperleukocytosis (2 cases), and thrombocytopenia below 50000 cells/microL (5 cases). In 16 patients (61.5%) the envenomation was classified as moderate and this type was predominant. Six cases were classified as severe. No fatal case was reported. Treatment included the administration of specific antivenom in 14 cases (in all severe and half of moderate cases) and symptomatic treatment applied in all cases.

CONCLUSIONS

Moderate envenomation prevailed among the patients analyzed in the study. Antivenom treatment is primarily necessary in cases of severe (grade 3) and in some cases of moderate (grade 2) envenomation, especially in patients with persistent or recurring hypotension.

Authors+Show Affiliations

Toxicological Unit, T Marciniak Hospital, Wrocław, Poland. naladgam@op.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20591372

Citation

Magdalan, Jan, et al. "Vipera Berus Bites in the Region of Southwest Poland--a Clinical Analysis of 26 Cases." Wilderness & Environmental Medicine, vol. 21, no. 2, 2010, pp. 114-9.
Magdalan J, Trocha M, Merwid-Lad A, et al. Vipera berus bites in the Region of Southwest Poland--a clinical analysis of 26 cases. Wilderness Environ Med. 2010;21(2):114-9.
Magdalan, J., Trocha, M., Merwid-Lad, A., Sozański, T., & Zawadzki, M. (2010). Vipera berus bites in the Region of Southwest Poland--a clinical analysis of 26 cases. Wilderness & Environmental Medicine, 21(2), 114-9. https://doi.org/10.1016/j.wem.2010.01.005
Magdalan J, et al. Vipera Berus Bites in the Region of Southwest Poland--a Clinical Analysis of 26 Cases. Wilderness Environ Med. 2010;21(2):114-9. PubMed PMID: 20591372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vipera berus bites in the Region of Southwest Poland--a clinical analysis of 26 cases. AU - Magdalan,Jan, AU - Trocha,Małgorzata, AU - Merwid-Lad,Anna, AU - Sozański,Tomasz, AU - Zawadzki,Marcin, Y1 - 2010/01/25/ PY - 2010/7/2/entrez PY - 2010/7/2/pubmed PY - 2010/10/21/medline SP - 114 EP - 9 JF - Wilderness & environmental medicine JO - Wilderness Environ Med VL - 21 IS - 2 N2 - OBJECTIVE: Vipera berus is the only naturally occurring venomous snake in Poland. Its venom is primarily vasculotoxic and evokes both local and systemic findings. The aim of the study was to review a series of clinical cases of V berus bites occurring in southwest Poland. METHODS: The charts of 26 patients (age range, 16-66 years; mean, 42 years) hospitalized with V berus bites were retrospectively analyzed using a data collection tool. Demographic and clinical data were extracted. RESULTS: The most common local findings of envenomation were edema of the bitten limb with associated extravasations observed in 24 (92.3%) patients, but in only 1 (3.8%) case did the edema spread to the trunk. In 22 (84.6%) cases edema disappeared within 2 weeks after the bite. Systemic disturbances observed in the patients were: shock (1 case), mild transient hypotension (1 case), prolonged hypotension (3 cases), bronchospasm and laryngeal edema (1 case), diarrhea (1 case), transient supraventricular arrhythmias (2 cases), neutrophilic hyperleukocytosis (2 cases), and thrombocytopenia below 50000 cells/microL (5 cases). In 16 patients (61.5%) the envenomation was classified as moderate and this type was predominant. Six cases were classified as severe. No fatal case was reported. Treatment included the administration of specific antivenom in 14 cases (in all severe and half of moderate cases) and symptomatic treatment applied in all cases. CONCLUSIONS: Moderate envenomation prevailed among the patients analyzed in the study. Antivenom treatment is primarily necessary in cases of severe (grade 3) and in some cases of moderate (grade 2) envenomation, especially in patients with persistent or recurring hypotension. SN - 1545-1534 UR - https://www.unboundmedicine.com/medline/citation/20591372/Vipera_berus_bites_in_the_Region_of_Southwest_Poland__a_clinical_analysis_of_26_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1080-6032(10)00042-6 DB - PRIME DP - Unbound Medicine ER -