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Title: Arboreal green pit vipers (genus Trimeresurus) of south-east Asia: Bites by T. albolabris and T. macrops in Thailand and a review of the literature
Authors: R. A. Hutton
Somchai Looareesuwanzj
May Ho
Kamolrat Silamut
Pomthep Chanthavanich
Juntra Karbwang
Wichai Supanaranond
V. Vejcho
Chaisin Viravan
R. E. Phillips
D. A. Warrell
Mahidol University
Trang Hospital
Weatherall Institute of Molecular Medicine
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1990
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.84, No.6 (1990), 866-874
Abstract: In Thailand 29 patients were proved to have been bitten by arboreal green pit vipers: 24 by Trimeresurus albolabris and 5 by T. macrops. They were studied in order to define the clinical effects of envenoming, to characterize the haemostatic abnormalities and assess the efficacy of Thai Red Cross antivenom. T. macrops caused only local painful swelling, neutrophil leucocytosis and thrombocytopenia. T. albolabris caused more severe envenoming with local blistering and necrosis, shock, spontaneous systemic bleeding, defibrination, thrombocytopenia and leucocytosis. There was no evidence of disseminated intravascular coagulation, but fibrinolytic activity was increased. Platelet function was normal. The product of admission venom antigen concentration and the delay between bite and admission was significantly higher in defibrinated patients than in those without severe coagulopathy. Antivenom (5 ampoules intravenously) restored blood coagulability, but there was persistent venom antigenaemia, associated in some cases with recurrent coagulopathy. The literature on bites by south Asian green pit vipers of the genus Trimeresurus is reviewed; these bites are common medical problems and causes of morbidity. The identification of individual species is difficult, but may be important if antivenom is to be improved and used appropriately. © 1990, Oxford University Press. All rights reserved.
ISSN: 18783503
Appears in Collections:Scopus 1969-1990

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