title: Bilateral Pulmonary Embolism Following a Viper Envenomation in France: A Case Report and Review.
abstract: Complications following snake bites are not common in France. We report the case of a bilateral pulmonary embolism following a viper envenomation in France.A healthy 72-year-old female presented with a lower limb hematoma following a viper bite. She was admitted at the hospital 2 days later and received low-molecular-weight heparin because of bed rest. Seven days later, she complained of thoracic pain and respiratory failure, and a bilateral pulmonary was diagnosed, without biological sign of neither disseminated intravascular coagulation nor coagulation trouble. Repeated lower limbs Doppler ultrasound were normal.This case is particularly interesting because it is only the 7th reported case of pulmonary embolism following a snake envenomation; moreover, it happened in France where poisonous snakes are very rare.Several hypotheses have been made to explain this late localized coagulopathy: an increased level of unstable fibrin produced by thrombin-like glycoproteins from the venom is one of them.
authors.affiliation: From the Rheumatology Unit (GB); Internal Medicine Unit (JC, MA), and Department of Infectious Diseases, Nantes University Hospital, Nantes, France (SP, CB).
authors.forename: Géraldine
authors.initials: G
authors.lastname: Bart
authors.forename: Samuel
authors.initials: S
authors.lastname: Pineau
authors.forename: Charlotte
authors.initials: C
authors.lastname: Biron
authors.forename: Jérôme
authors.initials: J
authors.lastname: Connault
authors.forename: Mathieu
authors.initials: M
authors.lastname: Artifoni
mesh_terms: D000368:Aged; D000818:Animals; D005260:Female; D005602:France; D006406:Hematoma / Q000209:etiology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D011655:Pulmonary Embolism / Q000209:etiology*; D012909:Snake Bites / Q000150:complications*; D017819:Viperidae