title: Vipera berus bites in Eastern Poland--a retrospective analysis of 15 case studies.
abstract: OBJECTIVE
  The common European adder (Vipera berus) is the only venomous snake that is found naturally in Poland. This study presents the epidemiological and clinical characteristics of V.berus bites in Eastern Poland and describes the methods of poisoning treatment.
  
  
  METHODS
  Medical documentation of 15 patients hospitalized at the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok between 1998-2010 because of V.berus bite was analyzed retrospectively.
  
  
  RESULTS
  Most of the snakebites were accidental (86.7% of the cases). The bites usually took place in forests (66.7% of the cases). The majority of patients were bitten in the lower extremity (8 cases, 53.3%), most often in the area of ankle joint. The severity of poisoning was usually minor to moderate. The most common local symptom was oedema (93.3% of the cases) and associated extravasations (73.3% of the cases). One patient experienced shock. Transient hypertension was observed in 3 cases. Mild coagulation disorders were present in 4 cases. In 4 cases, leukocytosis was observed. 86.7% of patients received the specific antivenom. No fatal outcome and no adverse reactions after antivenom administration were reported.
  
  
  CONCLUSIONS
  In the majority cases of poisoning with V.berus venom, the poisoning takes a mild course, limited to local oedema, but sometimes it may lead to severe complications. The only specific method of the treatment is antivenom administration.
authors.affiliation: Department of the Infectious Diseases and Neuroinfections, Medical University, Bialystok, Poland. adamo1805@mp.pl
authors.forename: Adam
authors.initials: A
authors.lastname: Garkowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Czupryna
authors.forename: Agata
authors.initials: A
authors.lastname: Zajkowska
authors.forename: Sławomir
authors.initials: S
authors.lastname: Pancewicz
authors.forename: Anna
authors.initials: A
authors.lastname: Moniuszko
authors.forename: Maciej
authors.initials: M
authors.lastname: Kondrusik
authors.forename: Sambor
authors.initials: S
authors.lastname: Grygorczuk
authors.forename: Paweł
authors.initials: P
authors.lastname: Gołębicki
authors.forename: Michał
authors.initials: M
authors.lastname: Letmanowski
authors.forename: Joanna
authors.initials: J
authors.lastname: Zajkowska
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D012909:Snake Bites / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D014757:Viper Venoms / Q000506:poisoning*; D017819:Viperidae; D055815:Young Adult
chemical_list: D000997:Antivenins; D014757:Viper Venoms