Morphologic changes in intercostal muscle tissue associated with a viper (Agkistrodon halys blomhoffi) bite

This study examined a 73-year-old woman who had been bitten in the right thumb by a viper (Agkistrodon halys blomhoffi). She suffered acute renal failure and respiratory failure after the bite. On the 20th day, respiratory failure persisted, although she had recovered from renal failure. Intercostal muscles were obtained by biopsy on the 40th day after the bite. Specimens were observed with enzyme-histochemical and electron microscopic techniques. The size of muscle fibers varied. Most of the smaller muscle fibers were enzyme-histochemically type 2C fibers. This was considered to be the regenerative stage of acute rhabdomyolysis. Ultrastructurally, two opposite types of changes, degeneration and regeneration, were mixed in the same areas. Muscle fibers might be continuously degenerated, and the regenerative fibers might also be degenerated. This study suggests that some slow allergic reactions to snake venom might bear some relation to the degenerative changes.