Document Detail


Snake bites by the Papuan taipan (Oxyuranus scutellatus canni): paralysis, hemostatic and electrocardiographic abnormalities, and effects of antivenom.
MedLine Citation:
PMID:  7611559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
One hundred sixty-six patients with enzyme immunoassay-proven bites by taipans (Oxyuranus scutellatus canni) were studied in Port Moresby, Papua New Guinea. One hundred thirty-nine (84%) showed clinical evidence of envenoming: local signs were trivial, but most developed hemostatic disorders and neurotoxicity. The blood of 77% of the patients was incoagulable and 35% bled spontaneously, usually from the gums. Fifty-one per cent had microscopic hematuria. Neurotoxic signs (ptosis, ophthalmoplegia, bulbar paralysis, and peripheral muscular weakness) developed in 85%. Endotracheal intubation was required in 42% and mechanical ventilation in 37%. Electrocardiographic abnormalities (sinus bradycardia and septal T wave inversion) were found in 52% of a group of 69 unselected patients. Specific antivenom raised against Australian taipan venom was effective in stopping spontaneous systemic bleeding and restoring blood coagulability but, in most cases, it neither reversed nor prevented the evolution of paralysis even when given within a few hours of the bite. However, early antivenom treatment was associated statistically with decreased incidence and severity of neurotoxic signs. The low case fatality rate of 4.3% is attributable mainly to the use of mechanical ventilation, a technique rarely available in Papua New Guinea. Earlier use of increased doses of antivenoms of improved specificity might prove more effective.
Authors:
D G Lalloo; A J Trevett; A Korinhona; N Nwokolo; I F Laurenson; M Paul; J Black; S Naraqi; B Mavo; A Saweri
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  52     ISSN:  0002-9637     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-08-15     Completed Date:  1995-08-15     Revised Date:  2010-08-25    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  525-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Boroko.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Animals
Antivenins / therapeutic use*
Blood Coagulation Disorders / etiology,  therapy
Child
Child, Preschool
Elapid Venoms / poisoning*
Elapidae*
Electrocardiography / drug effects
Female
Heart / drug effects,  physiopathology
Hemostasis / drug effects
Humans
Immunoenzyme Techniques
Male
Middle Aged
Nervous System Diseases / etiology,  therapy
Papua New Guinea
Paralysis / etiology*,  therapy
Prospective Studies
Snake Bites / complications,  physiopathology*,  therapy
Time Factors
Grant Support
ID/Acronym/Agency:
//Wellcome Trust
Chemical
Reg. No./Substance:
0/Antivenins; 0/Elapid Venoms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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