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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

 

Sistrurus sp.

Case reports

Sistrurus miliarius
Ahlstrom et al. 1991: 1 S. miliarius bite; identification: morphological.


Sistrurus catenatus
Hankin et al. 1987: 1 S. catenatus bite; identification: geographical exclusion criterion.

Signs & symptoms

Local effects

Sistrurus miliarius
Local swelling with ecchymosis 3.5 h after the bite (Ahlstrom et al. 1991).

Muscular effects

Sistrurus miliarius
See below, "Laboratory and physical investigations".

Laboratory and physical investigations

1. Haemostasis
Type of haemostatic defect

Defibrin(ogen)ation (Kitchens 1992, pers. comm.).

DIC (Ahlstrom et al. 1991): this is a case report. It is not possible to extrapolate from this that there is a primary, DIC-inducing effect of the venom. Similar observations of this kind are necessary.


Haemostatic parameters

Sistrurus miliarius

 

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

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 PT: increased (Ahlstrom et al. 1991).
B Fibrinogen: decreased (Ahlstrom et al. 1991).
C D-dimers: increased (Ahlstrom et al. 1991).
D Platelets: decreased (Ahlstrom et al. 1991).


2. Creatinine
Sistrurus miliarius

Increased (acute renal failure in the context of DIC and/or rhabdomyolysis) (Ahlstrom et al. 1991).

 

3. Myoglobin in the urine
Sistrurus miliarius
Detectable (Ahlstrom et al. 1991).

Treatment (symptomatic)

Dialysis (Ahlstrom et al. 1991).