title: Severity factors of Mamushi (Agkistrodon blomhoffii) bite.
abstract: The factors determining the severity of a Mamushi (Agkistrodon blomhoffii) bite were analyzed based on the findings of our 34 cases and those appearing in the published work. It was not possible to forecast the final severity at the time of the patient's arrival and by the initial blood examination data. The maximal creatinine kinase (CK) values elevated proportionally with the time from the bite, and the relation approximated the equation of y = 300chi, where y represents the maximal CK value and chi indicates the time from the bite to the peak of CK level. In the severe cases which required intensive care, the level of the CK deviated remarkably from this line, and could be grossly distinguished from the non-severe cases. The maximal white blood cell (WBC) count also gradually increased in concordance with the time from the bite, and in addition, the WBC count of most of the severe cases exceeded 20,000/microL. This evidence suggests that the rate of the CK value elevation in relation to the time from the bite can be a useful indicator of the severity of a Mamushi bite, and the WBC count also reflects the severity.
authors.affiliation: Dermatology, Department of Anatomy, Biology and Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593, Japan. ookamoto@med.oita-u.ac.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Okamoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Oishi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hatano
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kai
authors.forename: Mizuki
authors.initials: M
authors.lastname: Goto
authors.forename: Aiko
authors.initials: A
authors.lastname: Kato
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Shimizu
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Katagiri
authors.forename: Sakuhei
authors.initials: S
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017836:Agkistrodon; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D012909:Snake Bites / Q000097:blood / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D003402:Creatine Kinase