Ein seltener toxikologischer Notfall: Schlangenbiss der Hornviper

Zusammenfassung

Wir berichten über die Verletzung eines 27-jährigen durch den Biss einer Hornviper in den linken Mittelfinger. Im Vordergrund standen Allgemeinsymptome (Thrombozytopenie, Fibrinolyse und Rhabdomyolyse), die eine intensivmedizinische engmaschige Überwachung und die Verabreichung eines Antiserums erforderlich machten. Lokal war hingegen nur eine Nekrektomie mit anschließender Spalthautdeckung notwendig.

Abstract

We report on the snakebite injury of a 27-year-old male patient by a saharan horned viper in his left middle finger. General symptoms (thrombocytopenia, fibrinolysis and rhabdomyolysis) were leading and required observation at close intervals on intensive care unit and the application of a specific antiserum. At the finger a local necrectomy for the haemorrhagic necrosis was needed, followed by split-skin grafting for tissue coverage.

Schlüsselwörter

Schlangenbiss

Key words

snakebite

Literatur

• 1 Ahmad Z. A study of the knowledge and attitudes of emergency physicians and plastic surgeons in the management of snakebites.  Eur J Plast Surg. 2009;  32 141-145
• 2 Zimmerman J, Mann G, Kaplan HY. et al . Envenoming by Cerastes vipera – a report of two cases.  Transactions of the royal society of tropical medicine and hygiene. 1981;  75 702-705
• 3 Schneemann R, Cathomas R, Laidlaw ST. et al . Life-threatening envenoming by the Saharan horned viper (Cerastes cerastes) causing micro-angiopathic haemolysis, coagulopathy and acute renal failure: clinical cases and review.  QJ Med. 2004;  97 717-727
• 4 Lifshitz M, Kastel H, Harman-Boehm I. Cerastes cerastes envenomation in an 18-year-old female: a case report.  Toxicon. 2002;  40 1227-1229
• 5 Lifshitz M, Kapelushnik J, Ben-Harosh M. et al . Disseminated intravascular coagulation after Cerastes vipera envenomation in a 3-year-old child: a case report.  Toxicon. 2000;  38 1593-1598
• 6 Rowland S, Pederson WC. The management of snake (pit viper) bites.. In: Green DP, Hotchkiss RN, Pederson WC, Wolfe SW (Eds.): Green's operative hand surgery. 5th ed. Philadelphia: Elsevier Churchill Livingstone; 2005: 2006-2013

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