Document Detail


Acute demyelinating encephalomyelitis after anti-venom therapy in Russell's viper bite.
MedLine Citation:
PMID:  20237970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Russell's viper is a commonly encountered venomous snake in India. Morbidity and mortality following envenomation and the treatment thereof are frequent. We report a rarely seen complication after a treated Russell's viper bite.
CASE REPORT: A 36-year-old male farmer received 30 vials polyvalent anti-snake venom after a viper bite to his right leg. Improvement in initial hematemesis and circulatory shock was followed by acute renal failure managed with regular hemodialysis. He displayed no abnormalities on neurological examination at admission. Fourth day onwards his neurologic status started deteriorating with development of behavioral abnormalities, hemi-spatial neglect of left upper limb, paralysis of left facial nerve, left upper limb, and right lower limb. Acute disseminated encephalomyelitis was confirmed on magnetic resonance imaging (MRI) of brain with typical spectroscopic characteristics. High dose methyl prednisolone was administered and a rapid recovery followed.
CONCLUSION: Russell's viper bite followed by treatment with antivenom may be complicated by the development of immune complex mediated demyelination and development of acute disseminated encephalomyelitis. MRI spectroscopy helps in early identification of demyelination and in a definite diagnosis. Treatment with corticosteroids was associated with resolution of symptoms in this case.
Authors:
S Tripathy; P K Routray; A K Mohapatra; M Mohapatra; S C Dash
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of medical toxicology : official journal of the American College of Medical Toxicology     Volume:  6     ISSN:  1556-9039     ISO Abbreviation:  J Med Toxicol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-11-09     Revised Date:  2013-07-31    
Medline Journal Info:
Nlm Unique ID:  101284598     Medline TA:  J Med Toxicol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  318-21     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Intensive Care, Kalinga Institute of Medical Sciences, Patia, Bhubaneswar, India. swagi7@rediffmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Animals
Antivenins / adverse effects*
Demyelinating Diseases / diagnosis,  etiology*
Encephalomyelitis / diagnosis,  etiology*
Humans
Magnetic Resonance Imaging
Male
Russell's Viper*
Snake Bites / therapy*
Viper Venoms / immunology*
Chemical
Reg. No./Substance:
0/Antivenins; 0/Viper Venoms
Comments/Corrections

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