title: Envenoming by Crotalid Snake Chinese Moccasin Agkistrodon Acutus Bite - A Case Report.
abstract: Although the bites caused by snakes from former Agkistrodon family in the areas of occurrence are not rare and even have certain epidemiologic importance, in case of envenoming by Deinagkistrodon acutus the clinical studies and case reports are very sporadic. This case report describes the envenoming of a private snake breeder bitten by young Chinese moccasin Deinagkistrodon acutus to the thumb of his left hand. He sought for a medical help immediately after snakebite. Patient presented with a local oedema on the affected limb, extending up to the half of the forearm. Laboratory examinations showed serious haemostatic disturbance with defibrination syndrome, immeasurably prolonged clotting times and extreme elevation of D-dimers. No other obvious clinical symptoms were present. Fibrinogen and fresh frozen plasma were administered because the antivenom was not available immediately. The specific antivenom was urgently imported 22 hours after the bite and administered at a dose of two vials three times until laboratory haemocoagulation parameters returned back to physiological values.
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic. valenta@vfn.cz.
authors.forename: Jiří
authors.initials: J
authors.lastname: Valenta
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Stach
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Michálek
mesh_terms: D000328:Adult; D017836:Agkistrodon; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D018153:Czech Republic; D004487:Edema / Q000209:etiology; D005340:Fibrinogen / Q000627:therapeutic use; D006230:Hand Injuries / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D010949:Plasma; D012909:Snake Bites / Q000628:therapy*
chemical_list: D000997:Antivenins; D005340:Fibrinogen