title: [Envenomation by exotic snakes].
abstract: Snake bite envenoming in tropical areas affects an estimated one million people according to the World Health Organization. Two studies showed that annual mortality is between 30,000 and 50,000 people. Clinically cobra and viper envenoming are the most well known but several other snakes cause characteristic manifestations allowing species-specific diagnosis. Immuno-enzymatic tests are a useful diagnostic tool that is currently expanding but remains available only in developing countries because of cost. Treatment consists mainly of serotherapy in the most severe cases. Use of purified products and fragments active specifically on toxins and enzymes is both safer and more effective. Heparinotherapy should be used only when indicated by clinical manifestations and hemostasis testing. Management of envenoming must be organized in function of antivenom availabilities in a given region. Future improvements in immuno-enzymatic tests and antivenoms should allow more successful treatment of severe snake bite envenoming.
authors.affiliation: Départment d'Anesthésie-Réanimation-Urgences, Hôpital d'Instruction de Armées Laveran, Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Aubert
authors.forename: L
authors.initials: L
authors.lastname: De Haro
authors.forename: J
authors.initials: J
authors.lastname: Jouglard
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D014943:Global Health; D006801:Humans; D007124:Immunoenzyme Techniques; D012909:Snake Bites / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012911:Snakes / Q000145:classification
chemical_list: D000997:Antivenins
vernacular_title: Les envenimations par les serpents exotiques.