Snake venom poisoning in Greece. Experiences with 147 cases.
BACKGROUND
Snake venom poisoning is a medical emergency requiring immediate attention. Bites from poisonous European snakes can lead to local tissue damage and systemic symptoms. Vipera ammodytes accounts for the most envenomation in Greece.


METHODS
The demographic and epidemiological characteristics, clinical symptoms and signs, laboratory findings, treatment, and outcome of 147 consecutive victims of V. ammodytes admitted to our hospital from 1988 to 2003 were reviewed and analyzed.


RESULTS
The most common symptoms and signs included fang marks (100%), pain (100%), swelling (98.64%), ecchymosis (60.54%), tachycardia (32.65%), fainting or dizziness (29.93%), fever (23.13%), enlargement of regional lymph nodes (17.69%), nausea (16.33%), hypotension (13.61%), and vomiting (12.93%). The main complications were reduced range of motion, thrombophlebitis, local hemorrhagic blister formation, skin bleeding, rhabdomyolysis, reduced sensation, acute renal failure, necrosis with tissue loss, carpal tunnel syndrome, compartment syndrome, Kounis syndrome, and digit amputation.


CONCLUSIONS
A V. ammodytes bite is a potentially serious event that requires immediate hospital care. Yet, the majority of victims can be treated successfully with conservative methods. No deaths occurred in our series.
Frangides
Christos Y
CY
Department of Internal Medicine, Saint Andrews State General Hospital, Patras, Greece.
Koulouras
Vasilios
V
Kouni
Sophia N
SN
Tzortzatos
Gerasimos V
GV
Nikolaou
Athanasios
A
Pneumaticos
John
J
Pierrakeas
Christos
C
Niarchos
Constantinos
C
Kounis
Nicholas G
NG
Koutsojannis
Constantinos M
CM