Severe disseminated intravascular coagulation in a child envenomated by echis coloratus and succesful treatment with monovalent equine immunoglobulin g antivenom.

Severe disseminated intravascular coagulation in a child envenomated by echis coloratus and succesful treatment with monovalent equine immunoglobulin g antivenom. Toxicon. 2019 May 28;: Authors: Glatstein M, Lerman L, Friedman S, Carbell G, Munchak I, Valla U, Scolnik D, Hoyte C Abstract BACKGROUND: The Echis coloratus (Burton Carpet viper), a highly toxic venomous viper snake belonging to the family of Viperidae, is responsible for a large proportion of the venomous snakebites in Israel and Palestinian Authority. Thrombolytic enzymes are present in Echis coloratus venom and significant coagulopathy is typical after envenomation. Here we report a case of envenomation by an Echis coloratus viperidae snake that involved severe coagulopathy as the main systemic manifestation with severe bleeding after fasciotomy. CASE DETAILS: A 3-year-old boy was admitted to our pediatric critical care unit after a snakebite to his left hand, 2-3 hours post-bite. Based on the possibility of compartment syndrome, a fasciotomy was performed before administration of antivenom. At our hospital, he had anincoagulable prothrombin time (PT) and activated partial thromboplastin time (aPTT), with low fibrinogen levels. The snake responsible for the bite was later identified as a 38-cm long Echis coloratus. Five vials of Israeli monovalent antivenom were subsequently administered with step-wise improvement in hematological abnormalities. Other treatments...
Source: Toxicon - Category: Toxicology Authors: Tags: Toxicon Source Type: research