Complications of Bothrops, Porthidium, and Bothriechis snakebites in Colombia. A clinical and epidemiological study of 39 cases attended in a university hospital

Otero, Rafael; Gutiérrez, Johnayro; Mesa, Marı́a Beatriz; Duque, E.; Rodriguez, Orlando Javier Ramos; Arango, Jorge Luis Parra; Gómez, Felipe; Toro-Montoya, Ana Isabel; Cano, Fidel; Rodríguez, Libia María; Caro, Erika; Martı́nez, Jorge; Cornejo, William; Gómez, Luis Mariano; Uribe, Francisco Luis; Cárdenas, Silvia; Núñez, Vitelbina; Dı́az, Abel

doi:10.1016/s0041-0101(02)00104-6

Cited by 215 publications

(188 citation statements)

References 19 publications

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“…79,80 Severe envenomation by B. asper, Bothrops punctatus, Porthidium nasutum, and B. schlegelii snakebites in Colombia were characterized by local necrosis, local and systemic bleeding, and/or hypotension or renal failure. 81 The toxin composition of the venoms of B. asper and P. nasutum have not been reported. However, preliminary results from our laboratories indicate that these venoms, like the B. schlegelii venom, contain a large amount of bradykinin-potentiating peptides (BPPs, Table 3).…”

Section: )Ecesgdccdqcrmentioning

confidence: 99%

Snake Venomics and Antivenomics of the Arboreal Neotropical Pitvipers Bothriechis lateralis and Bothriechis schlegelii

et al. 2008

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We report the comparative proteomic characterization of the venoms of two related neotropical arboreal pitvipers from Costa Rica of the genus Bothriechis, B. lateralis (side-striped palm pit viper) and B. schlegelii (eyelash pit viper). The crude venoms were fractionated by reverse-phase HPLC, followed by analysis of each chromatographic fraction by SDS-PAGE, N-terminal sequencing, MALDI-TOF mass fingerprinting, and collision-induced dissociation tandem mass spectrometry of tryptic peptides. The venom proteomes of B. lateralis and B. schlegelii comprise similar number of distinct proteins belonging, respectively, to 8 and 7 protein families. The two Bothriechis venoms contain bradykinin-potentiating peptides (BPPs), and proteins from the phospholipase A 2 (PLA 2 ), serine proteinase, L-amino acid oxidase (LAO), cysteine-rich secretory protein (CRISP), and Zn 2+ -dependent metalloproteinase (SVMP) families, albeit each species exhibit different relative abundances. Each venom also contains unique components, for example, snake venom vascular endothelial growth factor (svVEGF) and C-type lectin-like molecules in B. lateralis, and Kazal-type serine proteinase inhibitor-like proteins in B. schlegelii. Using a similarity coefficient, we estimate that the similarity of the venom proteins between the two Bothriechis taxa may be <10%, indicating a high divergence in their venom compositions, in spite of the fact that both species have evolved to adapt to arboreal habits. The major toxin families of B. lateralis and B. schlegelii are SVMP (55% of the total venom proteins) and PLA 2 (44%), respectively. Their different venom toxin compositions provide clues for rationalizing the distinct signs of envenomation caused by B. schlegelii and B. lateralis. An antivenomic study of the immunoreactivity of the Instituto Clodomiro Picado (ICP) polyvalent antivenom toward Bothriechis venoms revealed that L-amino acid oxidase and SVMPs represent the major antigenic protein species in both venoms. Our results provide a ground for rationalizing the reported protection of the ICP polyvalent antivenom against the hemorrhagic, coagulant, defibrinating, caseinolytic and fibrin(ogen)olytic activities of Bothriechis (schlegelii, lateralis) venoms. However, these analyses also evidenced the limited recognition capability of the polyvalent antivenom toward a number of Bothriechis venom components, predominantly BPPs, svVEGF, Kazal-type inhibitors, some PLA 2 proteins, some serine proteinases, and CRISP molecules.

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Section: )Ecesgdccdqcrmentioning

confidence: 99%

Snake Venomics and Antivenomics of the Arboreal Neotropical Pitvipers Bothriechis lateralis and Bothriechis schlegelii

et al. 2008

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“…Similarly, patients with crotaline venom-induced rhabdomyolysis may go on to develop compartment syndrome. The incidence of compartment syndrome after crotaline envenomation has been reported in several case series and varies from less than 2% to greater than 10% [64][65][66].…”

Section: What Is the Mechanism By Which Xenobiotics Cause Compartmentmentioning

confidence: 99%

Case Files of the Medical Toxicology Fellowship at Drexel University

Vearrier

Curtis

2011

J. Med. Toxicol.

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A 28-year-old female was brought to the emergency department (ED) by her roommate after a suicide attempt, in which the patient took 29 capsules of an over-the-counter (OTC) sleep aid containing 50 mg of diphenhydramine (DPH) per capsule, for a total of 1450 mg, and consumed 100 ml of vodka. Her weight was 67 kg, yielding a dose of 22 mg/kg DPH. When a roommate arrived home from work several hours later, he noticed that the patient was walking aimlessly through the house and that "she was out of it." The patient subsequently informed the roommate of her suicide attempt, at which point he brought her by car to our ED. According to the patient, the ingestion occurred 9 h prior to arrival.In the ED, the patient complained of bilateral tingling and numbness in her legs and feet that had started within the last 4 h. She had a subjective sensation of inability to control the muscles in her legs and leg weakness. The patient denied any history of leg trauma, recent strenuous physical activity, or recent prolonged inactivity. Her medical history was significant for cervical dysplasia status post surgical excision and major depressive disorder. The patient denied taking any other prescribed or OTC medications, which her roommate corroborated.Physical examination revealed a young, disheveled female with normal body habitus. Initial vital signs included a temperature of 36.4°C, heart rate 123 beats/ min, respiratory rate 18 breaths/min, blood pressure 112/ 83 mm Hg, and pulse oximetry of 98% on room air. Pupils were 6 mm bilaterally and sluggishly reactive to light. Extraocular movements were intact. The mucous membranes of the oropharynx were dry. Cardiac examination was significant for a regular tachycardia, while the pulmonary examination was normal. Abdominal examination was significant for bowel sounds being present but decreased. The patient was alert and oriented to self and place, but not to time. She was able to answer simple questions, but was slow to respond. Strength, sensation, and deep tendon reflexes were normal. No ataxia or tremor was present. Extremity examination was significant for mottled skin color on the anterior legs bilaterally. Dorsalis pedis and posterior tibialis pulses were normal, as was sensation, strength, and capillary refill throughout the bilateral lower extremities. What is the Pharmacology of DPH?DPH is a first-generation H 1 antihistamine. It belongs to the ethanolamine subclass of antihistamines along with carbinoxamine, clemastine, dimenhydrinate, and doxylamine. Histamine receptors are categorized into four subtypes This case report was presented in poster form at the EAPCCT conference in 2009 in Stockholm, Sweden.

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“…In Colombia, severe poisoning by Bothrops asper, Bothrops punctatus, Porthidium nasutum and Bothriechis schlegelii bite has been characterized and includes local necrosis, systemic and local bleeding, hypotension and renal failure (11).…”

Section: Laboratory Testsmentioning

confidence: 99%

Envenomation caused by the bite of the snake Bothriechis schlegelii. Report of two cases in Colombia

Ruiz¹

2017

Case reports

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La mordedura de serpiente del género Bothriechis es frecuente en regiones de Colombia como el eje cafetero. Debido a sus costumbres arborícolas y su actitud defensiva, por lo general estas serpientes muerden a agricultores en sus miembros superiores y rostro. En Colombia, la incidencia de accidentes provocados por este tipo de serpiente aún no ha sido estimada con exactitud, ya que existen deficiencias en el registro de los mismos, así como desconocimiento de este reptil por parte del personal de salud que trabaja en su área de influencia. En este artículo se presentan dos casos de mordeduras por B. schlegelii ocurridos en Colombia en 2015. El primero, un hombre de 55 años con mordedura en mano izquierda, que desarrolló parestesias y edema hasta antebrazo sin otros hallazgos y que fue sometido a tratamiento con antivipérido polivalente de Probiol®, con resolución completa del evento. Por su parte, el segundo caso es el de un hombre de 62 años que fue mordido en mano izquierda, presentando emesis, diaforesis, edema hasta el hombro y tiempos de coagulación prolongados, sin sangrado; el paciente requirió ocho ampollas de antivipérido polivalente del Instituto Nacional de Salud (Colombia), con lo que se logró normalización de tiempos de coagulación y resolución completa del evento.

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Complications of Bothrops, Porthidium, and Bothriechis snakebites in Colombia. A clinical and epidemiological study of 39 cases attended in a university hospital

Cited by 215 publications

References 19 publications

Snake Venomics and Antivenomics of the Arboreal Neotropical Pitvipers Bothriechis lateralis and Bothriechis schlegelii

Snake Venomics and Antivenomics of the Arboreal Neotropical Pitvipers Bothriechis lateralis and Bothriechis schlegelii

Case Files of the Medical Toxicology Fellowship at Drexel University

Envenomation caused by the bite of the snake Bothriechis schlegelii. Report of two cases in Colombia

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