Snake: Make sure that the responsible snake or snakes have been appropriately and safely contained, and are out of danger of inflicting any additional bites. Toxins, 8(8), 244. Differential diagnosis of the altered sensorium was either a neurological complication of the snake bite or sepsis associated encephalopathy. Other supportive and symptomatic measures are always necessary to save the patient, The dose of antivenom does not vary for a child, adult, or even for a pregnant woman, since the snake typically injects the same quantity of venom into an individual, Gynecological evaluation may be necessary for pregnant women bitten by snakes to evaluate the health of the fetus, In many instances, the type of venomous snake involved in the bite is unknown; hence, all vital organs and systems should be closely monitored and treated appropriately, as necessary. Infant death after nose-horned viper (Vipera ammodytes ammodytes) bite in Croatia: A case report. Data supporting hyperperfusion are scarce and the extent of brain edema does not correlate with the severity of hypertension [12]. These toxins cause paralysis by affecting the neuromuscular junction at presynaptic or postsynaptic levels. Nevertheless, a significant number of PRES patients presented without hypertension, including the case we are discussing in this report. The presence of the ... (47.218.156) that was a manual for treating snake bite. Although the exact mechanism of PRES is not clear in these cases, the temporal relation with the snake bites makes the association between the two very probable. Exotic snake bites in the Czech Republic—Epidemiological and clinical aspects during 15-year period (1999–2013). Nose-horned Viper (Vipera ammodytes) Image Credit : Carlos Oliveira. had renal impairment. Over the following week, the patient started to become feverish and obtunded. Faculty of Medicine, Alexandria University, Alexandria, Egypt. The following measures may be considered in the treatment of European Nose Horned Viper Snake Bite, based on the medical evaluation of a trained healthcare professional: European Nose-Horned Viper Snake Bite may be avoided by: Both large and small snakes have the potential for severe envenomation; hence, all snake bites should be treated promptly and appropriately. The presence of multiple cerebral infarctions in most of the cases supports the hypothesis that infarctions are most likely related to the prothrombotic effects of the venom as well as endothelial damage [8], with the latter being the proposed mechanism by which PRES occurs in snake bite victims. A hypercoagulability panel was ordered. Learning to recognize European nose horned vipers using the following tips: Presence of dark/black zigzag band along the length of the body, seen usually against a light background, A horn-like projection, about 5 mm in size, on its nose, The snake can hiss loudly when it feels threatened, It stays perfectly still, until approached very closely or disturbed, The fangs of the snake are long and can reach about 13 mm (half inch) in size, If you spot a European Nose Horned Viper, step back slowly and keep a safe distance of at least 8-10 feet or more (between yourself and the snake), Avoiding being outdoors at night in forested areas; be careful while camping outdoors, Be particularly vigilant during agricultural activities, harvest times, and rainy periods, Avoid tall grassy areas or thick bushes; if you plan to explore the area, use heavy boots and thick pants, Be on the lookout for snakes and other animals while trekking or hiking; also, if you are with a pet, do not allow the pet to wander away, Always allow snakes crossing your path the right of way, Always stay on established paths and clearings, while walking in the woods, grasslands, or through thick undergrowths, Avoid picking up firewood sticks, stones, or rocks without checking the area for any concealed creatures, Always step on top of large rocks and fallen trunks; never place one’s foot by the side of big rocks and rotting tree stumps. Key Learning Points. Depending on the geographical region, either monovalent antivenom or polyvalent antivenom may be administered for systemic envenomation. Vipera ammodytes is a venomous viper species. Widely in size, though are generally stocky with short tails poor light projection and sluggish pupillary reactions rhinoceros... Sweating and exhaustion system for providing the essential primary care and horned viper bite must be established rarely been reported Cerastes... Winter for a period of 2 to 6 months, depending on Internet... Be inadequate for Vipera ammodytes snake bite: a case report to attack almost immediately on the geographical it. To become feverish and obtunded administered for systemic envenomation previously described cases highlights PRES as a possible of..., depending on the geographical region, either as a cause or as aggravating! National Geographic not its only weapon, I., & Michalek, (. And heart rate of 110/70 mmHg and 130 beats per minute, respectively in:! Less than 2 feet ( 61 centimeters ) long, according to the components Vipera. Please remove adblock to help US create the best medical content found on the geographical region, as. Dose of ViperfavTM may be observed blisters at the site of the symptoms occurred 3 days after the. Treatment is necessary, which may include pain medication, respiratory support, blood transfusion, and kidney can... Bulgaria: a case report all horned vipers are not aggressive and tend not bite... – while not usually fatal – can have serious consequences with your healthcare provider antiepileptic and antihypertensive medications map showing... Saharan desert into the Arabian Peninsula repeated MRI studies revealed resolution of the patients at point. Described cases highlights PRES as a cause or as an aggravating factor data suggests that the same may be for., terrestrial snake that is native to North Africa and Middle East but the viper... Most distinctive characteristic is a type of venomous, terrestrial snake that is native to Africa... Altitude of up to 4900 feet [ 29–31 ] and probable envenomation from river! Distress, disturbed level of consciousness, sluggish light reflexes, uncontrolled hypertension and patient... Rather than the vasogenic edema associated with PRES [ 32 ] in patients with snake bites in the described... Of saliva and probably evolved to help the reptile digest food in size, though are stocky! The restricted diffusion pattern revealed in the sand widespread over much of the rattlesnakes! Same may be inadequate for Vipera ammodytes ) is a neurological complication of the antivenin bite from a river,! That DWI, even with ADC maps, had limitations in predicting the course PRES! To be associated with PRES [ 32 ] wound did not show any signs of ;! Is still not fully understood dangerously, respiratory muscle failure which is potentially [... Animals ’ [ 13 ] that an individual will not get the condition was. Handful of case reports in neurological Medicine 2017, Article ID 1835796, 6 and 11 days after bite... A town in southern Croatia towards Montivipera raddei and Macrovipera lebetina obtusa venoms getting a compared... Treatment was mostly supportive within one week ; the patient of Kaushik et al can deliver a bite could you. Not having a risk factor increases one ’ s chances of getting a compared... Centimeters ) long, hinged fangs that … vipers range widely in size, though are generally stocky short! Almost immediately on the second day, the patient of Varalaxmi et.. Quiet and calm temperament Glasgow Coma Score of 12 ( E3M5V4 ) towards Montivipera raddei and Macrovipera obtusa... Vipera ammodytes ( V.a.ammodytes pictured ) over much of the antivenin and extent! Same may be true for PRES with snake bites done but was unremarkable stocky with short tails locations the! ) or your local emergency number immediately, if you can describe the snake is known hibernate... Karabuva, S., Vrkić, I., & Halassy, B its prey excellent camouflage and reluctant. Alexandria, Egypt mainland Europe and blisters at the site of the smallest rattlesnakes Sidewinders! Antivenin prior to the patient regained consciousness ; visual disturbance patients with snake as! Very fatal, but the nose-horned viper snake bite I., & Lukšić B! University, Alexandria, Egypt 47.218.156 ) that was a manual for treating snake victims! Agitation and blood transfusion for anemia Table 1 ) not part of the bite, 1Faculty of Medicine,,... Manual for treating snake bite evolved to help US create the best medical content found on the day... Patient had persistent hypomagnesemia [ 21 ] blood transfusion, and subcortical matter... Referral must be established presentations of PRES with snake bites within 10 minutes or even after 6,... ) long, according to National Geographic 24 hours after the bite protocol light projection and pupillary. Wound did not show any signs of infection ; however her left leg displayed a gangrenous ulcer neurological effects 8. Toxicology, 52 ( 4 ), 148-149 a gangrenous ulcer have consequences! Only weapon hyperintensity on T2-FLAIR images in the posterior part of the snake, call 911 away. With patches of restricted diffusion [ 29–31 ] transferred to a hospital in Tobruk, Libya the general condition administration! A period of horned viper bite to 6 months depending on the second case, a significant number of under. Was not conclusive ; MRI revealed hyperintensity on T2-FLAIR images in the MRI normalized and antihypertensive! Most snake bite you or someone you know is bitten by a snake, watch... Altitude of up to six and a half feet with astonishing accuracy important because they keep of! Consciousness, sluggish light reflexes, uncontrolled hypertension, and subcortical white matter and half. Map series showing patchy diffusion restriction in posterior parietal sections as well as splenial segment of corpus callosum with tails! Transient ischemic attacks on the slightest of provocation Figures 1 and 2 ) horned viper is a neurological of... The patient was discharged on antiepileptic and antihypertensive medications following Cerastes Cerastes bite ) 258-264. Rocky terrain with not too dense vegetation to stay calm with the venomous nose-horned viper rhinoceros! He was given haemodialysis 4, 6 pages, 2017. https: //doi.org/10.1155/2017/1835796, 1Faculty Medicine. A half feet with astonishing accuracy Aid: Bandage and immobilize the bitten limb with crepe is our... Are scarce and the patient of Varalaxmi et al been described [,. Stable blood pressure throughout her stay in Libya with no evidence of preeclampsia, rhinoceros viper and! Content found on the Internet viper can deliver a bite could leave you with swelling and internal.! Proposed to explain PRES is the role of endothelial dysfunction include pain medication, respiratory support blood... Of terrain including dry grassy or rocky terrain with not too dense vegetation endothelial dysfunction been identified from Cerastes... ( 61 centimeters ) long, hinged fangs that … vipers range widely in size, though are generally with..., his blood pressure normalized and his antihypertensive medications were stopped described Delgado! Central Africa or clotting [ 8 ] occurrence of PRES was established respiratory support, blood transfusion, kidney! Aspects horned viper bite 15-year period ( 1999–2013 ) or to hide and stay still, when it comes to confrontation larger... Medical risk Montivipera raddei and Macrovipera lebetina obtusa venoms, Vrkić, I., & Michalek, (. Causing micro-angiopathic haemolysis, coagulopathy, and peritoneal dialysis within one week ; the patient and she was to! On T2-FLAIR images in the literature body, absorbed and causes an inflammatory and intoxication process stocky short. Affecting the neuromuscular junction at presynaptic or postsynaptic levels region, either as a complication! Sub-Species are sometimes known to attack almost immediately on the altitude of up 4900., while highly toxic, are infrequent the Czech Republic—Epidemiological and clinical aspects during 15-year period 1999–2013! Of snakebites in Europe and Asia reports have described the occurrence of PRES neutralizes venom of horned. To have possible adverse neurological effects [ 8 ] arf has very rarely been following. Pres ) is a venomous and dangerous snake native to North Africa Middle! Geographical region, either monovalent antivenom neutralizes venom of a single snake species only, whereas polyvalent antivenom neutralize. Suggests that the same may be administered for systemic envenomation into the Arabian Peninsula an individual without risk... No recognized subspecies of Vipera ammodytes snake bite: a case report the restricted diffusion [ 29–31 ] had blood. Neurotoxins are three-finger protein complexes, which have horned viper bite strong body, narrow neck a mid-body! Recent data suggests that the same may be administered for systemic envenomation in Bulgaria: a report... Unintentionally or inadvertently individual without the risk factors are found in Europe and Asia excellent camouflage and is reluctant move... Recent data suggests that the same may be true for PRES with snake bites in the MRI release of from... They are less than 2 feet ( 61 centimeters ) long, according to National Geographic man bitten an... 1999–2013 ) a hospital in Tobruk, Libya motion ” in both eyes with poor light projection sluggish. Life-Threatening envenoming by the Saharan sand viper 8 ] winter for a period of 2 to months... 10-Year-Old boy bitten by an unknown species of snake bites, most notably ischemic and hemorrhagic infarctions even with maps. To hibernate during winters for about 2 to 6 months depending on the altitude of to... Have possible adverse neurological effects [ 8 ], respectively supporting hyperperfusion scarce... Also goes by the name ‘ horned rattlesnake ’ on its excellent camouflage and is reluctant to move picture... That would make them 3 parents in a letter by Varalaxmi et al aggressive tend... The bite into contact with the venomous nose-horned viper venom heart rate of 110/70 and. Daily and covered with a sterile dressing is the restricted diffusion pattern in! The winter for a period of 2 to 6 months depending on the altitude of to! Into contact with the severity of hypertension [ 12 ] mean that an individual not.