Case Report: Recent Case Reports of Levant Blunt-Nosed Viper Macrovipera lebetina obtusa Snakebites in Iran

Am J Trop Med Hyg. 2021 Apr 5;104(5):1870-1876. doi: 10.4269/ajtmh.20-1640.

Abstract

Envenomation and death resulting from snakebites represent a significant public health problem worldwide, particularly in tropical and subtropical regions. The WHO has defined snakebite as a neglected tropical health concern. Bites from Macrovipera lebetina obtusa usually cause life-threatening systemic hemodynamic disturbances, reduced functionality of the kidneys, and other serious symptoms, including hypotension shock, edema, and tissue necrosis, at the bite site. Herein, we highlight five cases of M. l. obtusa envenomation that presented with wide-ranging manifestations. Many recovered cases were left with long-term musculoskeletal disabilities. In a particular case, a 15-year-old male patient was envenomed in his palm by an 80-cm M. l. obtusa. Within 12 hours, swelling extended to near the shoulder. Fasciotomy was performed on the forearm and part of the upper arm of this patient. Symptoms of severe localized pain and swelling, dizziness, weakness, low blood pressure, and itching around the bite area were documented. The patient remained in the hospital for 13 days.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Antivenins / therapeutic use*
  • Child
  • Edema / diagnosis
  • Edema / drug therapy*
  • Edema / pathology
  • Edema / surgery
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Hypotension / diagnosis
  • Hypotension / drug therapy*
  • Hypotension / pathology
  • Hypotension / surgery
  • Iran
  • Loratadine / therapeutic use
  • Male
  • Necrosis / diagnosis
  • Necrosis / drug therapy*
  • Necrosis / pathology
  • Necrosis / surgery
  • Snake Bites / diagnosis
  • Snake Bites / drug therapy*
  • Snake Bites / pathology
  • Snake Bites / surgery
  • Viper Venoms / administration & dosage
  • Viper Venoms / toxicity*
  • Viperidae / physiology*

Substances

  • Antivenins
  • Histamine Antagonists
  • Viper Venoms
  • Loratadine