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Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
North America
 
Mexico and Central America
 
South America and the West Indies
 
Europe
 
North Africa, Near and Middle East
 
Central and Southern Africa
 
The Far East
 
Indian Subcontinent and Southeast Asia
 
Australia and the Pacific Islands
 
 
 
 
 
 
 
 

Clinic

 

Crotalus polystictus

Case reports

C. polystictus
Mexico
Hardy 1982: 1 case; identification morphological.

Signs & symptoms

Local effects

Mild local pain; rapidly progressive swelling, ecchymosis; blistering within 3 days; necrosis (1 cm2) (Hardy 1982).

Neurological effects

Fasciculations of the musculature of the hand and finger of the bitten extremity; hypaesthesia of the hands, feet and face; metallic taste (Hardy 1982).

Morbidity

Necrosis (Hardy 1982).

Laboratory and physical investigations

1. Haemostasis
Type of haemostatic defect
Defibrin(ogen)ation. Platelet aggregation (Hardy 1982).

Haemostatic parameters


Overview haemostasis
                 
B
 
                      
 
 H CT (FSP) Tc PT aPTT TT I FSP D II V VIII X XIII PC ATIII PI tPA α2AP
       
 
C
      
 
A
                        
 

Essential

bed-side

tests

 Tests for full clinical assessment Tests for research purposes
H haemorhagic effects
+ definite evidence in
human envenoming
CT full blood clotting test
(FSP)  FSP rapid test
Tc platlets
PT prothrombin time
aPTT partial thromboplastin time
TT thrombin time
I fibrinogen
FSP  fibrinogen split products
D D-dimer
II, V, VII, X, XIII
  clotting factors
PC protein C
ATIII antithrombin III
PI plasminogen
tPA tissue plasmin activator
α2AP α2-antiplasmin
 
In this overview, the deviations from normal
are recorded for those haemostasis para-
meters only, for which good evidence is
documented in the literature.

 

A Fibrinogen: serial measurements showed a clear decrease (and renewed increase coinciding with antivenom administration) (Hardy 1982).
B FSP: maximum 160 μg/ml (normal 2–10 μg/ml) (Hardy 1982).
C Platelets: minimum 145,000/mm³ (normal >150,000/mm³) (Hardy 1982).

Treatment (specific)

 

Antivenoms

1. Crotalidae Polyvalent Immune Fab Antivenom, ovine (immunized with Crotalus adamanteus, Crotalus atrox, Crotaus scutulatus ssp. and Agkistrodon piscivorus) / CroFab™, Savage Laboratories, Melville, New York

 

see Crotalus sp.

 


2. Wyeth antivenom (Crotalidae), polyvalent, Philadelphia, USA (no longer in use)

Efficacy

  1. With regard to neurological symptoms (see above): 5 vials of Wyeth antivenom (Crotalidae): symptoms disappeared simultaneously with antivenom administration (Hardy 1982).
  2. With regard to the haemostatic effect: 5 vials of Wyeth antivenom (Crotalidae): no progression of an incipient haemostatic defect (see above) coinciding with antivenom administration (Hardy 1982).