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Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera berus) Bite in Romania.
Toxins (Basel). 2022 07 18; 14(7)T

Abstract

Most cases of envenomation by common European vipers (Vipera berus) have not been reported to have neurotoxic manifestations. However, these manifestations have been demonstrated in some cases of envenomation by subspecies of V. berus, found in the Carpathian Basin region of south-eastern Europe. Here, we report the case of a 5-year-old girl from the south of Romania who presented symptoms of neurotoxicity, as well as other systemic and local symptoms, after being bitten by an adder of the V. berus subspecies. Treatment consisted of monovalent antivenom, a corticosteroid, and prophylactic enoxaparin. Neurotoxic manifestations of envenomation as well as other local and systemic symptoms improved within 5 days of treatment. The presented case shows that venom from V. berus subspecies found in the Carpathian Basin can have neurotoxic effects. This case also confirmed the efficacy of monospecific antivenom treatment in bringing about rapid and complete remission, following envenomation.

Authors+Show Affiliations

Department of Pediatrics, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania. Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania.Department of Pediatrics, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania. Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania.Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania. Department of Epidemiology, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania.Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania.Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania. Department of Pediatric Surgery and Orthopedics, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania.Romanian Association of Herpetology, 400006 Cluj-Napoca, Romania.Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, IRCCS, Maugeri Foundation, 27100 Pavia, Italy.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

35878238

Citation

Nițescu, Gabriela Viorela, et al. "Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera Berus) Bite in Romania." Toxins, vol. 14, no. 7, 2022.
Nițescu GV, Ulmeanu CE, Crăciun MD, et al. Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera berus) Bite in Romania. Toxins (Basel). 2022;14(7).
Nițescu, G. V., Ulmeanu, C. E., Crăciun, M. D., Ciucă, A. M., Ulici, A., Ghira, I., & Lonati, D. (2022). Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera berus) Bite in Romania. Toxins, 14(7). https://doi.org/10.3390/toxins14070500
Nițescu GV, et al. Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera Berus) Bite in Romania. Toxins (Basel). 2022 07 18;14(7) PubMed PMID: 35878238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera berus) Bite in Romania. AU - Nițescu,Gabriela Viorela, AU - Ulmeanu,Coriolan Emil, AU - Crăciun,Maria-Dorina, AU - Ciucă,Alina Maria, AU - Ulici,Alexandru, AU - Ghira,Ioan, AU - Lonati,Davide, Y1 - 2022/07/18/ PY - 2022/06/17/received PY - 2022/07/07/revised PY - 2022/07/13/accepted PY - 2022/7/25/entrez PY - 2022/7/26/pubmed PY - 2022/7/28/medline KW - Berus Viper KW - child KW - common European viper KW - monospecific antivenom KW - neurotoxicity KW - south Romania JF - Toxins JO - Toxins (Basel) VL - 14 IS - 7 N2 - Most cases of envenomation by common European vipers (Vipera berus) have not been reported to have neurotoxic manifestations. However, these manifestations have been demonstrated in some cases of envenomation by subspecies of V. berus, found in the Carpathian Basin region of south-eastern Europe. Here, we report the case of a 5-year-old girl from the south of Romania who presented symptoms of neurotoxicity, as well as other systemic and local symptoms, after being bitten by an adder of the V. berus subspecies. Treatment consisted of monovalent antivenom, a corticosteroid, and prophylactic enoxaparin. Neurotoxic manifestations of envenomation as well as other local and systemic symptoms improved within 5 days of treatment. The presented case shows that venom from V. berus subspecies found in the Carpathian Basin can have neurotoxic effects. This case also confirmed the efficacy of monospecific antivenom treatment in bringing about rapid and complete remission, following envenomation. SN - 2072-6651 UR - https://www.unboundmedicine.com/medline/citation/35878238/Neurotoxicity_and_Other_Clinical_Manifestations_of_a_Common_European_Adder__Vipera_berus__Bite_in_Romania_ DB - PRIME DP - Unbound Medicine ER -