Abstract
This case report presents envenoming by the Chinese pit viper Protobothrops mangshanensis (formerly Zhaoermia) and its treatment. A 38 year old snake breeder suffered two-fang bites to elbow by a Chinese pit viper Protobothrops mangshanensis resulting in local edema of the affected arm. No other signs of envenoming appeared. On the 5(th) day following the bite a hematoma developed on the other arm which had been mechanically injured 14 days before. Laboratory testing revealed severe coagulopathy with hypofibrinogenemia and immeasurably prolonged coagulation times. As substitution therapy with fibrinogen and fresh frozen plasma was unsuccessful and specific antivenom is not produced, antivenin against some other Asian pit vipers GREEN PIT VIPER ANTIVENIN, Thai Red Cross, Thailand was applied. Three doses of antivenom reversed the course of the hemocoagulation disorder. The case confirms the persistence of active venom components affecting coagulation, difficulty in ameliorating the hemocoagulatin disorder caused by snake venom through substitution therapy and the effectiveness of delayed treatment using antivenin. It points out the potential risk of a clinically asymptomatic progress of envenoming by snake venoms containing hemocoagulation acting components, if the hemocoagulation disorder is not investigated and suitably treated. Therapy using the GREEN PIT VIPER ANTIVENIN, Thai Red Cross, Thailand in this case of envenomation by a Protobothrops mangshanensis bite proved to be applicable and the antivenom could be characterised as a paraspecific active.
Highlights
Protobothrops mangshanensis (Mangshan/Mount Mang/Chinese pit viper; local name: Mangshan Laotietou) is a rare endemic Asian pit viper
The venom components of pit vipers, as well as symptomatology and therapy of envenomation following a bite from other common pit vipers are known and have been recorded to a sufficient extent, this is the first description of envenoming by a Protobothrops mangshanensis bite
Components acting on fibrinogen, phospholipases A2 (PLA2) with hemorrhagic and myotoxic activity and other enzymatic components have been isolated in the laboratory from Protobothrops mangshanensis venom[1,2]
Summary
Protobothrops mangshanensis (Mangshan/Mount Mang/Chinese pit viper; local name: Mangshan Laotietou) is a rare endemic Asian pit viper. Classed with the Trimeresurus genus and subsequently Ermia and Zhaoermia genera, just a few hundred wild examples of this species exist throughout the locality of Mt Mang in Hunan Province, China. Given its attractive look and due to conservation efforts, this snake is occasionally found in captive reptile collections. Its habitus makes the species one of the largest members of pit vipers. The venom components of pit vipers, as well as symptomatology and therapy of envenomation following a bite from other common pit vipers are known and have been recorded to a sufficient extent, this is the first description of envenoming by a Protobothrops mangshanensis bite
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