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.
Smeets
R E
RE
Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands.
Melman
P G
PG
Hoffmann
J J
JJ
Mulder
A W
AW
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