Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.

Thirty-two patients with enzyme-immunoassay-proven death adder (Acanthophis sp.) bites were studied in Port Moresby, Papua New Guinea. Eighteen were envenomed; local signs were rare and none had incoagulable blood, but all except one had signs of neurotoxicity. Five (27.7%) envenomed patients requir...

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Main Authors: Lalloo, D, Trevett, A, Black, J, Mapao, J, Saweri, A, Naraqi, S, Owens, D, Kamiguti, A, Hutton, R, Theakston, R, Warrell, D
Format: Journal article
Language:English
Published: 1996
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author Lalloo, D
Trevett, A
Black, J
Mapao, J
Saweri, A
Naraqi, S
Owens, D
Kamiguti, A
Hutton, R
Theakston, R
Warrell, D
author_facet Lalloo, D
Trevett, A
Black, J
Mapao, J
Saweri, A
Naraqi, S
Owens, D
Kamiguti, A
Hutton, R
Theakston, R
Warrell, D
author_sort Lalloo, D
collection OXFORD
description Thirty-two patients with enzyme-immunoassay-proven death adder (Acanthophis sp.) bites were studied in Port Moresby, Papua New Guinea. Eighteen were envenomed; local signs were rare and none had incoagulable blood, but all except one had signs of neurotoxicity. Five (27.7%) envenomed patients required intubation and ventilation. One patient developed renal failure, previously undescribed following death adder bites. Laboratory investigations showed mild prolongation of prothrombin and partial thromboplastin times in some patients. In vitro studies showed that the venom contains anticoagulant activity, but does not cause fibrinogenolysis. In contrast to taipan envenoming, neurotoxicity did not progress after antivenom administration, and there was reversal of neurotoxicity, evident within 6 h, in three severely envenomed patients treated less than 12 h after the bite. One patient treated with antivenom and anticholinesterases had the most dramatic response to treatment; the optimum management of bites by this species may include prompt treatment with both antivenom and anticholinesterases in addition to effective first aid.
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spelling oxford-uuid:0228d331-5806-46ec-9474-ad3581b7d5902022-03-26T08:39:01ZNeurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0228d331-5806-46ec-9474-ad3581b7d590EnglishSymplectic Elements at Oxford1996Lalloo, DTrevett, ABlack, JMapao, JSaweri, ANaraqi, SOwens, DKamiguti, AHutton, RTheakston, RWarrell, DThirty-two patients with enzyme-immunoassay-proven death adder (Acanthophis sp.) bites were studied in Port Moresby, Papua New Guinea. Eighteen were envenomed; local signs were rare and none had incoagulable blood, but all except one had signs of neurotoxicity. Five (27.7%) envenomed patients required intubation and ventilation. One patient developed renal failure, previously undescribed following death adder bites. Laboratory investigations showed mild prolongation of prothrombin and partial thromboplastin times in some patients. In vitro studies showed that the venom contains anticoagulant activity, but does not cause fibrinogenolysis. In contrast to taipan envenoming, neurotoxicity did not progress after antivenom administration, and there was reversal of neurotoxicity, evident within 6 h, in three severely envenomed patients treated less than 12 h after the bite. One patient treated with antivenom and anticholinesterases had the most dramatic response to treatment; the optimum management of bites by this species may include prompt treatment with both antivenom and anticholinesterases in addition to effective first aid.
spellingShingle Lalloo, D
Trevett, A
Black, J
Mapao, J
Saweri, A
Naraqi, S
Owens, D
Kamiguti, A
Hutton, R
Theakston, R
Warrell, D
Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.
title Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.
title_full Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.
title_fullStr Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.
title_full_unstemmed Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.
title_short Neurotoxicity, anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders (Acanthophis sp.) in southern Papua New Guinea.
title_sort neurotoxicity anticoagulant activity and evidence of rhabdomyolysis in patients bitten by death adders acanthophis sp in southern papua new guinea
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