[Venomous and poisonous animals. II. Viper bites]

Area of Science:

• Herpetology
• Toxicology
• Clinical Medicine

Context:

• Viperidae family snakes are responsible for most global snake envenomations, excluding Australia.
• Envenomation presents with inflammatory signs like pain and edema, and biological markers such as hyperleukocytosis and proteinuria.
• Potential complications include hypotension, shock, hemorrhagic syndrome, and necrotic tissue damage.

Purpose:

• To outline the clinical manifestations and emergency situations arising from viper envenomation.
• To highlight the diagnostic challenges, particularly in cases of coagulation factor decrease without immediate symptoms.
• To emphasize the critical role and timing of antivenom therapy.

Summary:

• Viper envenomation can cause systemic effects including inflammation, shock, and severe coagulopathy.
• Hemorrhagic complications are a primary concern, potentially occurring even without overt clinical signs of envenomation.
• Necrotic complications necessitate vigilant medical and surgical monitoring.
• Intravenous antivenom is the sole effective treatment, with efficacy maintained even when administered days post-bite.

Impact:

• Informing emergency medical protocols for snakebite management.
• Guiding clinical surveillance for potential delayed complications.
• Underscoring the importance of timely antivenom administration for improving patient outcomes in viper envenomations.