Naslov
Clinical study and overview of the envenoming by lowland populations of the Balkan adder (Vipera berus bosniensis)

Autori
Malina, Tamás ; Krecsák, László ; Jelić, Dušan ; Maretić, Tomislav ; Tóth, Tamás ; Šiško, Marijan ; Pandak, Nenad

Vrsta, podvrsta
Ostale vrste radova, rukopis

Godina
2011

Ključne riječi
cranial nerve disturbances ; ptosis ; diplopia ; neurotoxicity ; autonomic disorders

Sažetak
Venom variations documented at several European Vipera in the last decades and we reported for the first time this phenomenon at the Common Adder (Vipera berus). We retrospectively survey the clinical picture of human envenomings by lowland populations of the Balkan adder, Vipera berus bosniensis, through 53 patients, admitted in SW Hungary, NW and NE Croatia. The maximum severity grade of bites was: none 5 (9.4%), mild 24 (45.2%), moderate 12 (22.6%) and severe 12 (22.6%). We report first a fatal envenoming by the Balkan adder, which occurred in the early 1950s in SW Hungary. Antivenom therapy applied in 27 cases, the European Viper Venom Antiserum® at twenty-two, Viperfav® at four and the Pasteur ER at one victim. There is a high incidence of neurotoxicity (x=12, 20.7%) mainly cranial nerve disturbances. Other neurotoxic symptoms were lower limb paralysis and dyspnoea, which have never been observed at V.b. berus bites ; these were only emphasized in the old works in V.b. bosniensis envenomings (i.e. 1930s). Further unusual features (i.e. hypertension and drowsiness) were also recorded. Hypokalaemia documented as a very unusual laboratory finding, it has never detected in the case of other European viper envenomation. Local symptoms are not as expressed as in the envenomings by C and N European adder populations. The systemic effects of bites by these lowland V. berus populations are highly different from those in C and N Europe, which supports the views that denote the Balkan populations as a separate taxonomic entity.

Izvorni jezik
Engleski

Znanstvena područja
Biologija, Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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