Epidemiology and clinical features of Hypnale nepa (hump-nosed pit viper) envenoming in Sri Lanka

The objectives of this study were to describe epidemiological and clinical features of H. nepa bites. A prospective observational study was conducted for patients admitted with H. nepa bites to Teaching Hospital, Ratnapura, Sri Lanka for 5 years commencing from June 2015. Species identification was done using a standard key. There were 14 (3.6%) patients with H. nepa bites of which 9 (64%) were males and 5 (36%) were females. Their age ranged from 20 to 73 years (median 37.5). Seven bites (50%) occurred on lower limbs. Majority of bites (10; 71%) happened at daytime [0600-1759 h] in tea estates (8; 57%). Most patients (8; 57%) were admitted within 1-3 h from bite. Hospital stay was 2.5 days (IQR 2-3). Local envenoming was observed in all patients including local pain and swelling [mild (7; 50%), moderate (5; 36%), severe (2; 14%)], local bleeding (1; 7%) and lymphadenopathy (1; 7%). Nonspecific features were observed in 3 (21%). Systemic manifestations were found in 2 (14%) including microangiopathic haemolytic anaemia and bradycardia. Two (14%) had myalgia. H. nepa bites frequently cause local envenoming. But, rarely systemic manifestations may occur.PMID:37321409 | DOI:10.1016/j.toxicon.2023.107194
Source: Toxicon - Category: Toxicology Authors: Source Type: research