[Severe hypofibrinegenemia after rattlesnake envenomation in France].
A 22-year-old man, who maintains illegally numerous exotic snakes at home (suburbs of Paris), was bitten by one of his Bresilian rattlesnakes, the lance-headed viper Bothrops moojeni, with grade III envenomation. The fibrinogen was less than 0,5 g/L, the prothombin time was 22%, the activated partial thromboplastin time was 94 seconds. The authors discuss the biological and clinical management of this defibrination, due to defibrinogenating proteases (thrombin-like enzymes), present in Bothrops moojeni venom. The patient received 7 vials of an antivenom directed to another crotal, Bothrops lanceolatus. Despite the importance of defibrinogenation, there was only a few clinical evidence of bleeding, according to the literature. The normalization of coagulation studies occured only after day 11. This case-report outlines the danger of the increase of exotic snakes maintained as pet in France and the difficulties to obtain specific antivenoms.
Mérens
A
A
Service de biologie médicale, France.
Petitjeans
F
F
Gidenne
S
S
Debien
B
B
De Rudnicki
S
S
Fontan
E
E
Hervé
V
V
Samson
T
T
Foissaud
V
V
D000328:Adult; D000818:Animals; D000829:Animals, Domestic; D000997:Antivenins / Q000008:administration & dosage*; D001780:Blood Coagulation Tests; D017837:Bothrops; D003435:Crotalid Venoms; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D012909:Snake Bites / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
D000997:Antivenins; D003435:Crotalid Venoms; D005340:Fibrinogen