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Protobothrops mucrosquamatus Bites to the Head: Clinical Spectrum from Case Series

Ying-Tse Yeh1, Min-Hui Chen2, Julia Chia-Yu Chang3,1

  • 1Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan.

The American Journal of Tropical Medicine and Hygiene
|June 27, 2018
PubMed

Insights

Head bites from Protobothrops mucrosquamatus pit vipers cause significant swelling and potential complications. Prompt treatment with species-specific antivenom led to successful recovery in all reported cases.

Area of Science:

  • Herpetology
  • Toxicology
  • Clinical Medicine

Background:

  • Protobothrops mucrosquamatus (Trimeresurus mucrosquamatus) is a medically significant pit viper in Southeast Asia.
  • Envenomation typically affects extremities, with head bites being rare and poorly understood.

Observation:

  • This report details three cases of P. mucrosquamatus bites to the head.
  • Patients experienced progressive head and neck swelling, with two developing anterior chest wall involvement.

Findings:

  • Two patients showed mild thrombocytopenia.
  • One patient required intubation due to airway obstruction and acute renal impairment.
  • All patients received high-dose, species-specific antivenom and recovered within a week without adverse reactions.

Implications:

  • This study highlights the potential severity of P. mucrosquamatus head envenomation.
  • It underscores the importance of timely and aggressive antivenom administration for favorable outcomes.
  • Further research into the specific toxins and management of head envenomation is warranted.

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