Venomous snake bites: clinical diagnosis and treatment

Table 2 Typical symptoms and laboratory data to be evaluated

	Mamushi	Habu	Yamakagashi
Typical symptoms	Local pain, swelling, severely decreased platelet count^a, diplopia, blurred vision, nausea^b, vomiting^b, stomachache^b, diarrhea^b, cyanosis^b	Local swelling, necrosis, bleeding at the bite site, vomiting^b, cyanosis^b, loss of consciousness^b, hypotension^b, compartment syndrome	Nasal bleeding, gum bleeding, bleeding from the bite site, headache^b
Laboratory data to be evaluated routinely	CBC, CK, BUN, Cre, Na, K, Cl, Fibrinogen, FDP, d-dimer, PT, APTT
Typical laboratory findings	CK↑		FDP >100 μg/mL
Typical laboratory findings	Plt <10,000/μL^a		Fibrinogen <100 mg/dL
Laboratory data to be evaluated additionally	Myoglobin, CK-MB	Myoglobin	AT-III, TAT, PIC

CBC complete blood count, Plt platelet count, CK creatine kinase, BUN blood urea nitrogen, Cre creatinine, FDP fibrinogen degradation products, PT prothrombin time, APTT activated partial thromboplastin time AT-III antithrombin III, TAT thrombin-antithrombin III complex, PIC plasmin-α2-plasmin inhibitor complex.
^aVenom is injected into the blood vessel directly.
^bIn severe cases.

ISSN: 2052-0492