title: Dark green pit viper (Trimeresurus popeorum) bite: clinical and serial coagulation profiles in 51 cases.
abstract: Trimeresurus popeorum, a dark green pit viper, is commonly found in Southeast Asia. This study describes the clinical picture and blood studies of 51 patients bitten by this snake. Affected limbs were swollen; and hemorrhagic blebs in fingers and toes were found in 12 patients. Lymphangitis was observed in 4 instances. Six individuals exhibited hypofibrinogenemia of 0-84 mg/dl, and 2 cases developed thrombocytopenia and bleeding. The presence of venom in the blood of these patients was demonstrated. Positive fibrin degradation products of 40-320 micrograms/ml were observed in 6 cases with hypofibrinogenemia, and in 8 other cases. Nineteen patients had short euglobulin lysis times of 51.8 +/- 24.7 min. Hyperfibrinogenemia of 626.7 +/- 288.9 mg/dl was found in 18 cases. Apart from bleeding, there were no systemic symptoms. Hypofibrinogenemia became normal in 3-12 days. The clinical course in all patients was uneventful, and none received antivenin.
authors.affiliation: Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Visudhiphan
authors.forename: A
authors.initials: A
authors.lastname: Tonmukayakul
authors.forename: S
authors.initials: S
authors.lastname: Tumliang
authors.forename: B
authors.initials: B
authors.lastname: Dumavibhat
authors.forename: A
authors.initials: A
authors.lastname: Piankijagum
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001777:Blood Coagulation; D002648:Child; D003435:Crotalid Venoms / Q000097:blood; D005260:Female; D005337:Fibrin / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis*; D005342:Fibrinolysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012712:Serum Globulins; D012909:Snake Bites / Q000097:blood*
chemical_list: D003435:Crotalid Venoms; D005338:Fibrin Fibrinogen Degradation Products; D012712:Serum Globulins; D005337:Fibrin; D005340:Fibrinogen