title: [Ischaemic stroke secondary to viper envenomation in Morocco in the absence of adequate antivenom].
abstract: An ischaemic stroke is a rare complication of viper envenomation that is due to multifactorial pathophysiological mechanisms. The authors describe the case of a 55-year-old patient bitten by the viper Cerastes cerastes. The patient was admitted to the intensive care unit with multiple organ failure, disseminated intravascular coagulopathy, rhabdomyolysis, anuria and elevated troponin level. The persistent disturbance of consciousness has motivated a brain scan which has revealed a bifocal ischemic stroke. The complex venom of the species C. cerastes may induce hypotension, tissue necrosis, acute renal failure, bleeding disorders or DIC. With the cessation of a non-indicated heparintherapy and haemodialysis, the patient recovered in a few weeks despite the initial infusion of an unsuitable antivenom due to the late identification of the reptile. The preventive treatment of the complications of this envenomation is based on the infusion of the polyvalent antivenom Favirept(®).
authors.affiliation: Service de réanimation médicale, hôpital militaire d'instruction Mohammed V, Rabat, Maroc. chanimedaicha@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Chani
authors.forename: A
authors.initials: A
authors.lastname: Abouzahir
authors.forename: C
authors.initials: C
authors.lastname: Haimeur
authors.forename: N Drissi
authors.initials: ND
authors.lastname: Kamili
authors.forename: G
authors.initials: G
authors.lastname: Mion
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D001002:Anuria / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000150:complications / Q000209:etiology / Q000628:therapy*; D003221:Confusion / Q000209:etiology; D004211:Disseminated Intravascular Coagulation; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco; D010976:Platelet Count; D011516:Prothrombin / Q000032:analysis; D012206:Rhabdomyolysis / Q000150:complications; D012909:Snake Bites / Q000150:complications* / Q000628:therapy*; D020521:Stroke / Q000150:complications / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014336:Troponin / Q000097:blood; D014757:Viper Venoms; D017819:Viperidae
chemical_list: D000997:Antivenins; D004232:Diuretics; D014336:Troponin; D014757:Viper Venoms; D011516:Prothrombin