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Delayed administration of Vipera xanthina palaestinae antivenin.
J Toxicol Clin Toxicol. 1997; 35(3):257-61.JT

Abstract

INTRODUCTION

Vipera xanthina palaestinae is the most widely distributed venomous snake in Israel, accounting for most envenomations. A specific equine antivenin is efficacious against both systemic and local manifestations if given within hours. This study sought to determine if delayed vipera xanthina palaestinae antivenin can be effective.

METHODS

Patients who had been bitten by vipera xanthina palaestinae during 1991-1995 were evaluated. Those who continued to deteriorate beyond 24 h post envenomation, in spite of treatment or because of delayed diagnosis, were given vipera xanthina palaestinae antivenin.

RESULTS

Ten patients were included in the study. Vipera xanthina palaestinae was identified in seven and diagnosis was considered probable in three patients. On admission, eight patients had local signs and seven patients had mild to severe systemic manifestations. The local signs were remarkable and progressive in all patients. In five, systemic signs and laboratory abnormalities were delayed as well. The time range for delayed antivenin administration was 1-6 days after envenomation. Following antivenin administration, progression of local signs ceased in all patients and swelling regressed within 24 h. In nine patients this occurred within 6 h.

CONCLUSION

Vipera xanthina palaestinae antivenin administration should be considered in patients with envenomations complicated by marked and progressive local signs, delayed systemic signs and laboratory abnormalities more than 24 h after envenomation.

Authors+Show Affiliations

Bentur Y
Israel Poison Information Center, Rambam Medical Center, Haifa, Israel, ipic@rambam.health.gov.il
Zveibel F
No affiliation info available
Adler M
No affiliation info available
Raikhlin B
No affiliation info available

MeSH

AdolescentAdultAnimalsAntiveninsChildChild, PreschoolFemaleHumansIsraelLongitudinal StudiesMaleMiddle AgedPoison Control CentersSnake BitesTime FactorsViper VenomsViperidae

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9140319

Citation

Bentur, Y, et al. "Delayed Administration of Vipera Xanthina Palaestinae Antivenin." Journal of Toxicology. Clinical Toxicology, vol. 35, no. 3, 1997, pp. 257-61.
Bentur Y, Zveibel F, Adler M, et al. Delayed administration of Vipera xanthina palaestinae antivenin. J Toxicol Clin Toxicol. 1997;35(3):257-61.
Bentur, Y., Zveibel, F., Adler, M., & Raikhlin, B. (1997). Delayed administration of Vipera xanthina palaestinae antivenin. Journal of Toxicology. Clinical Toxicology, 35(3), 257-61.
Bentur Y, et al. Delayed Administration of Vipera Xanthina Palaestinae Antivenin. J Toxicol Clin Toxicol. 1997;35(3):257-61. PubMed PMID: 9140319.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delayed administration of Vipera xanthina palaestinae antivenin. AU - Bentur,Y, AU - Zveibel,F, AU - Adler,M, AU - Raikhlin,B, PY - 1997/1/1/pubmed PY - 1997/1/1/medline PY - 1997/1/1/entrez SP - 257 EP - 61 JF - Journal of toxicology. Clinical toxicology JO - J Toxicol Clin Toxicol VL - 35 IS - 3 N2 - INTRODUCTION: Vipera xanthina palaestinae is the most widely distributed venomous snake in Israel, accounting for most envenomations. A specific equine antivenin is efficacious against both systemic and local manifestations if given within hours. This study sought to determine if delayed vipera xanthina palaestinae antivenin can be effective. METHODS: Patients who had been bitten by vipera xanthina palaestinae during 1991-1995 were evaluated. Those who continued to deteriorate beyond 24 h post envenomation, in spite of treatment or because of delayed diagnosis, were given vipera xanthina palaestinae antivenin. RESULTS: Ten patients were included in the study. Vipera xanthina palaestinae was identified in seven and diagnosis was considered probable in three patients. On admission, eight patients had local signs and seven patients had mild to severe systemic manifestations. The local signs were remarkable and progressive in all patients. In five, systemic signs and laboratory abnormalities were delayed as well. The time range for delayed antivenin administration was 1-6 days after envenomation. Following antivenin administration, progression of local signs ceased in all patients and swelling regressed within 24 h. In nine patients this occurred within 6 h. CONCLUSION: Vipera xanthina palaestinae antivenin administration should be considered in patients with envenomations complicated by marked and progressive local signs, delayed systemic signs and laboratory abnormalities more than 24 h after envenomation. SN - 0731-3810 UR - https://www.unboundmedicine.com/medline/citation/9140319/Delayed_administration_of_Vipera_xanthina_palaestinae_antivenin_ DB - PRIME DP - Unbound Medicine ER -