title: Severe coagulopathy after Vipera ammodytes ammodytes snakebite in Bulgaria: a case report.
abstract: The case report presents a severe coagulopathy in a 56-year-old man following envenomation by the snake (Vipera ammodytes ammodytes) on his left hand. Initially the man was in shock, with an extremely low blood pressure and tachycardia. Local signs included a painful blister formation on the envenomation site. Twenty-four hours later, the man developed acute thrombocytopenia (platelets number 10 x 10(9)/l) and ecchimoses formation on the affected limb and on the left side of his body due to a disseminated intravascular coagulation syndrome, which lasted 13 days and required repeated administration of blood products, antivenin and supportive treatment. The patient was discharged from the hospital after 18 days in a good condition. The case report indicates that the coagulopathy may be a serious life-threatening complication after V. ammodytes ammodytes snakebite.
authors.affiliation: Toxicology Clinic, University Multiprofile Hospital for Active Treatment and Emergency Medicine N. I. Pirogov, 21 Totleben" Blvd., 1606 Sofia, Bulgaria.
authors.forename: I
authors.initials: I
authors.lastname: Marinov
authors.forename: V N
authors.initials: VN
authors.lastname: Atanasov
authors.forename: E
authors.initials: E
authors.lastname: Stankova
authors.forename: D
authors.initials: D
authors.lastname: Duhalov
authors.forename: S
authors.initials: S
authors.lastname: Petrova
authors.forename: A
authors.initials: A
authors.lastname: Hubenova
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002031:Bulgaria; D019963:Clinical Chemistry Tests; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced* / Q000628:therapy; D004359:Drug Therapy, Combination; D006225:Hand; D006403:Hematologic Tests; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D012769:Shock / Q000139:chemically induced; D012909:Snake Bites / Q000503:physiopathology* / Q000628:therapy; D013610:Tachycardia / Q000139:chemically induced; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D014757:Viper Venoms / Q000633:toxicity*; D017819:Viperidae / Q000502:physiology*
chemical_list: D000997:Antivenins; D014757:Viper Venoms