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Sri Lankan green pit viper (Trimeresurus trigonocephalus) bites in Deniyaya: A clinico-epidemiological study.
Toxicon. 2019 Nov; 169:34-37.T

Abstract

Green pit viper (Trimeresurus trigonocephalus) is endemic to Sri Lanka and bites are reported from tropical rain forest and plantation areas. As scant data exists on clinico-epidemiological features of Sri Lankan green pit viper bite, objective of this study was to address this knowledge gap. A prospective observational study was conducted in Base Hospital Deniyaya from October 2013 to September 2015. Green pit viper as the offending snake was identified when the victims brought live or dead specimens. When the specimen was not available, green pit viper was identified by the victim pointing to preserved specimens and photographs of green pit viper and different similar appearing snakes. Clinical details were recorded during the hospital stay. Twenty four green pit viper bite patients (17-68 years) were studied. All cases were daytime bites despite green pit viper being a nocturnally active snake. Sixteen patients (67%) were bitten while they were working in tea plantation. Hands (42%), feet, (33%), forearms (8%), legs (8%), thighs (4%) and shoulders (4%) were the sites of bites. Thirteen (54%) had extensive limb swelling. Nine (38%) had local swelling and two had no swelling. Three (12.5%) developed haemorrhagic blisters. Four (17%) had regional lymphadenopathy. Two (8%) developed non clotting blood by the TWBCT. Green pit viper bites caused substantial morbidity. Risk factors included day time outdoor activities in bordering villages of tropical rain forests and occupation. Pain, extensive limb swelling and bite site swelling were prominent clinical features. However haemorrhagic blisters, regional lymphadenopathy and coagulopathy were reported. Nephrotoxicity and neurotoxicity were notably absent.

Authors+Show Affiliations

Base Hospital, Deniyaya, Sri Lanka. Electronic address: elapathawitharana@gmail.com.Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka.Department of Clinical Medicine, University of Ruhuna, Galle, Sri Lanka.Base Hospital, Deniyaya, Sri Lanka.Base Hospital, Deniyaya, Sri Lanka.Base Hospital, Deniyaya, Sri Lanka.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31348933

Citation

Witharana, E W R A., et al. "Sri Lankan Green Pit Viper (Trimeresurus Trigonocephalus) Bites in Deniyaya: a Clinico-epidemiological Study." Toxicon : Official Journal of the International Society On Toxinology, vol. 169, 2019, pp. 34-37.
Witharana EWRA, Gnanathasan A, Dissanayake AS, et al. Sri Lankan green pit viper (Trimeresurus trigonocephalus) bites in Deniyaya: A clinico-epidemiological study. Toxicon. 2019;169:34-37.
Witharana, E. W. R. A., Gnanathasan, A., Dissanayake, A. S., Wijesinghe, S. K. J., Kadahetti, S. C. L., & Rajapaksha, R. M. J. K. (2019). Sri Lankan green pit viper (Trimeresurus trigonocephalus) bites in Deniyaya: A clinico-epidemiological study. Toxicon : Official Journal of the International Society On Toxinology, 169, 34-37. https://doi.org/10.1016/j.toxicon.2019.07.011
Witharana EWRA, et al. Sri Lankan Green Pit Viper (Trimeresurus Trigonocephalus) Bites in Deniyaya: a Clinico-epidemiological Study. Toxicon. 2019;169:34-37. PubMed PMID: 31348933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sri Lankan green pit viper (Trimeresurus trigonocephalus) bites in Deniyaya: A clinico-epidemiological study. AU - Witharana,E W R A, AU - Gnanathasan,A, AU - Dissanayake,A S, AU - Wijesinghe,S K J, AU - Kadahetti,S C L, AU - Rajapaksha,R M J K, Y1 - 2019/07/23/ PY - 2018/10/03/received PY - 2019/07/11/revised PY - 2019/07/23/accepted PY - 2019/7/28/pubmed PY - 2020/3/10/medline PY - 2019/7/27/entrez KW - Coagulopathy KW - Extensive limb swelling KW - Green pit viper KW - Hemorrhagic blisters KW - Trimeresurus trigonocephalus SP - 34 EP - 37 JF - Toxicon : official journal of the International Society on Toxinology JO - Toxicon VL - 169 N2 - Green pit viper (Trimeresurus trigonocephalus) is endemic to Sri Lanka and bites are reported from tropical rain forest and plantation areas. As scant data exists on clinico-epidemiological features of Sri Lankan green pit viper bite, objective of this study was to address this knowledge gap. A prospective observational study was conducted in Base Hospital Deniyaya from October 2013 to September 2015. Green pit viper as the offending snake was identified when the victims brought live or dead specimens. When the specimen was not available, green pit viper was identified by the victim pointing to preserved specimens and photographs of green pit viper and different similar appearing snakes. Clinical details were recorded during the hospital stay. Twenty four green pit viper bite patients (17-68 years) were studied. All cases were daytime bites despite green pit viper being a nocturnally active snake. Sixteen patients (67%) were bitten while they were working in tea plantation. Hands (42%), feet, (33%), forearms (8%), legs (8%), thighs (4%) and shoulders (4%) were the sites of bites. Thirteen (54%) had extensive limb swelling. Nine (38%) had local swelling and two had no swelling. Three (12.5%) developed haemorrhagic blisters. Four (17%) had regional lymphadenopathy. Two (8%) developed non clotting blood by the TWBCT. Green pit viper bites caused substantial morbidity. Risk factors included day time outdoor activities in bordering villages of tropical rain forests and occupation. Pain, extensive limb swelling and bite site swelling were prominent clinical features. However haemorrhagic blisters, regional lymphadenopathy and coagulopathy were reported. Nephrotoxicity and neurotoxicity were notably absent. SN - 1879-3150 UR - https://www.unboundmedicine.com/medline/citation/31348933/Sri_Lankan_green_pit_viper_(Trimeresurus_trigonocephalus)_bites_in_Deniyaya:_A_clinico-epidemiological_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-0101(19)30414-3 DB - PRIME DP - Unbound Medicine ER -