Envenomation by the great lakes bush viper (Atheris nitschei)

Benjamin W. Hatten, Antonio Bueso, Loren French, Robert Hendrickson, B (Zane) Horowitz

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction. We present a case of envenomation by a Great Lakes Bush Viper, Atheris nitschei. Atheris species are a group of snakes that are indigenous to the forested areas of Central Africa. Prior reports of envenomation by Great Lakes Bush Vipers were not found in a Medline search. However, reports of other Atheris species envenomations describe coagulopathy and acute renal failure. Case details. A 30-year-old male was bitten by a Great Lakes Bush Viper on his left hand. His left upper extremity was edematous with ecchymoses in the left axilla. There was bleeding from the bite site and from the patient's oral mucosa. Initial laboratory studies demonstrated significant derangement of hematologic parameters including anemia, thrombocytopenia, coagulopathy, and hypofibrinoginemia. There is no antivenom for this species. The patient was treated with blood products. Mucosal bleeding ceased within 12 h of admission. Discussion. Atheris nitschei is an African snake with no available antivenom. In this case, the patient developed coagulopathy with hemolytic anemia, thrombocytopenia, and low fibrinogen. Renal function remained unaffected. Despite the lack of specific antivenom or the use of plasmapheresis, our patient was successfully treated with transfusion of multiple blood products.

Original languageEnglish (US)
Pages (from-to)114-116
Number of pages3
JournalClinical Toxicology
Volume51
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Antivenins
Lakes
Snakes
Blood
Thrombocytopenia
Ecchymosis
Hemorrhage
Central Africa
Fibrinogen
Axilla
Plasmapheresis
Hemolytic Anemia
Mouth Mucosa
Bites and Stings
Acute Kidney Injury
Upper Extremity
Blood Transfusion
Anemia
Hand
Kidney

Keywords

  • Blood
  • Coagulation disorders
  • Snake bites
  • Thrombocytopenia
  • Viper venom
  • Viperidae

ASJC Scopus subject areas

  • Toxicology

Cite this

Envenomation by the great lakes bush viper (Atheris nitschei). / Hatten, Benjamin W.; Bueso, Antonio; French, Loren; Hendrickson, Robert; Horowitz, B (Zane).

In: Clinical Toxicology, Vol. 51, No. 2, 02.2013, p. 114-116.

Research output: Contribution to journalArticle

Hatten, Benjamin W. ; Bueso, Antonio ; French, Loren ; Hendrickson, Robert ; Horowitz, B (Zane). / Envenomation by the great lakes bush viper (Atheris nitschei). In: Clinical Toxicology. 2013 ; Vol. 51, No. 2. pp. 114-116.
@article{1efecf819cba40e8b83017fff33338ad,
title = "Envenomation by the great lakes bush viper (Atheris nitschei)",
abstract = "Introduction. We present a case of envenomation by a Great Lakes Bush Viper, Atheris nitschei. Atheris species are a group of snakes that are indigenous to the forested areas of Central Africa. Prior reports of envenomation by Great Lakes Bush Vipers were not found in a Medline search. However, reports of other Atheris species envenomations describe coagulopathy and acute renal failure. Case details. A 30-year-old male was bitten by a Great Lakes Bush Viper on his left hand. His left upper extremity was edematous with ecchymoses in the left axilla. There was bleeding from the bite site and from the patient's oral mucosa. Initial laboratory studies demonstrated significant derangement of hematologic parameters including anemia, thrombocytopenia, coagulopathy, and hypofibrinoginemia. There is no antivenom for this species. The patient was treated with blood products. Mucosal bleeding ceased within 12 h of admission. Discussion. Atheris nitschei is an African snake with no available antivenom. In this case, the patient developed coagulopathy with hemolytic anemia, thrombocytopenia, and low fibrinogen. Renal function remained unaffected. Despite the lack of specific antivenom or the use of plasmapheresis, our patient was successfully treated with transfusion of multiple blood products.",
keywords = "Blood, Coagulation disorders, Snake bites, Thrombocytopenia, Viper venom, Viperidae",
author = "Hatten, {Benjamin W.} and Antonio Bueso and Loren French and Robert Hendrickson and Horowitz, {B (Zane)}",
year = "2013",
month = "2",
doi = "10.3109/15563650.2012.763134",
language = "English (US)",
volume = "51",
pages = "114--116",
journal = "Clinical Toxicology",
issn = "1556-3650",
publisher = "Informa Healthcare",
number = "2",

}

TY - JOUR

T1 - Envenomation by the great lakes bush viper (Atheris nitschei)

AU - Hatten, Benjamin W.

AU - Bueso, Antonio

AU - French, Loren

AU - Hendrickson, Robert

AU - Horowitz, B (Zane)

PY - 2013/2

Y1 - 2013/2

N2 - Introduction. We present a case of envenomation by a Great Lakes Bush Viper, Atheris nitschei. Atheris species are a group of snakes that are indigenous to the forested areas of Central Africa. Prior reports of envenomation by Great Lakes Bush Vipers were not found in a Medline search. However, reports of other Atheris species envenomations describe coagulopathy and acute renal failure. Case details. A 30-year-old male was bitten by a Great Lakes Bush Viper on his left hand. His left upper extremity was edematous with ecchymoses in the left axilla. There was bleeding from the bite site and from the patient's oral mucosa. Initial laboratory studies demonstrated significant derangement of hematologic parameters including anemia, thrombocytopenia, coagulopathy, and hypofibrinoginemia. There is no antivenom for this species. The patient was treated with blood products. Mucosal bleeding ceased within 12 h of admission. Discussion. Atheris nitschei is an African snake with no available antivenom. In this case, the patient developed coagulopathy with hemolytic anemia, thrombocytopenia, and low fibrinogen. Renal function remained unaffected. Despite the lack of specific antivenom or the use of plasmapheresis, our patient was successfully treated with transfusion of multiple blood products.

AB - Introduction. We present a case of envenomation by a Great Lakes Bush Viper, Atheris nitschei. Atheris species are a group of snakes that are indigenous to the forested areas of Central Africa. Prior reports of envenomation by Great Lakes Bush Vipers were not found in a Medline search. However, reports of other Atheris species envenomations describe coagulopathy and acute renal failure. Case details. A 30-year-old male was bitten by a Great Lakes Bush Viper on his left hand. His left upper extremity was edematous with ecchymoses in the left axilla. There was bleeding from the bite site and from the patient's oral mucosa. Initial laboratory studies demonstrated significant derangement of hematologic parameters including anemia, thrombocytopenia, coagulopathy, and hypofibrinoginemia. There is no antivenom for this species. The patient was treated with blood products. Mucosal bleeding ceased within 12 h of admission. Discussion. Atheris nitschei is an African snake with no available antivenom. In this case, the patient developed coagulopathy with hemolytic anemia, thrombocytopenia, and low fibrinogen. Renal function remained unaffected. Despite the lack of specific antivenom or the use of plasmapheresis, our patient was successfully treated with transfusion of multiple blood products.

KW - Blood

KW - Coagulation disorders

KW - Snake bites

KW - Thrombocytopenia

KW - Viper venom

KW - Viperidae

UR - http://www.scopus.com/inward/record.url?scp=84873682338&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873682338&partnerID=8YFLogxK

U2 - 10.3109/15563650.2012.763134

DO - 10.3109/15563650.2012.763134

M3 - Article

C2 - 23327286

AN - SCOPUS:84873682338

VL - 51

SP - 114

EP - 116

JO - Clinical Toxicology

JF - Clinical Toxicology

SN - 1556-3650

IS - 2

ER -