Severe coagulopathy after a bite from a 'harmless' snake (Rhabdophis subminiatus).
European physicians may occasionally be confronted with cases of snake venom poisoning. The increasing interest in snakes as pets has unfortunately resulted in the importation of a number of venomous snakes. We here report the third known case in the medical literature of a patient who was exposed to severe coagulopathy after being bitten by a 'harmless' ringsnake (Rhabdophis subminiatus). The prolonged bleeding diathesis and the complete depletion of fibrinogen observed in our patient are consistent with the presence of a factor X activator in the venom, as has been described in a murine model. In agreement with the two previous case reports, we found no evidence of severe organ damage, despite active intravascular coagulation.
Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands.
R E
RE
Smeets
P G
PG
Melman
J J
JJ
Hoffmann
A W
AW
Mulder
D000328:Adult; D000818:Animals; D000829:Animals, Domestic; D001778:Blood Coagulation Disorders / Q000209:etiology*; D006801:Humans; D008297:Male; D009426:Netherlands; D012909:Snake Bites / Q000150:complications*; D012910:Snake Venoms / Q000009:adverse effects*
D012910:Snake Venoms