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Sample records for antivenins

  1. Anaphylaxis to scorpion antivenin and its management following envenomation by Indian red scorpion, Mesobuthus tamulus

    OpenAIRE

    Rahul Ramesh Bhoite; Girija Ramesh Bhoite; Dayanand N Bagdure; Himmatrao S Bawaskar

    2015-01-01

    Mesobuthus tamulus is an Indian red scorpion that is responsible for numerous cases of scorpion stings in the Indian subcontinent. Antivenin, vasodilators, and benzodiazepines are medications of choice in the treatment of scorpion bites. Adverse reactions such as anaphylaxis to antivenin have been infrequently described in the literature. We, herein, present a case of a 42-year-old man stung by Indian red scorpion while gardening at home in India, who presented with extreme pain at the sting ...

  2. Kenyan medicinal plants used as antivenin: a comparison of plant usage

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    Kisangau Daniel P

    2006-02-01

    Full Text Available Abstract The success of snake bite healers is vaguely understood in Kenya, partly due to their unknown materia medica and occult-mystical nature of their practice. A comparison is made of plants used in snake bite treatments by two culturally distinct African groups (the Kamba and Luo. Thirty two plants used for snakebite treatment are documented. The majority of the antidotes are prepared from freshly collected plant material – frequently leaves. Though knowledge of snake bite conditions etiological perceptions of the ethnic groups is similar, field ethnobotanical data suggests that plant species used by the two ethnic groups are independently derived. Antivenin medicinal plants effectively illustrate the cultural context of medicine. Randomness or the use of a variety of species in different families appears to be a feature of traditional snake bite treatments. A high degree of informant consensus for the species was observed. The study indicates rural Kenya inhabitants rely on medicinal plants for healthcare.

  3. Snake antivenins crisis intervention therapy%抗蛇毒血清危机干预研究

    Institute of Scientific and Technical Information of China (English)

    王永高; 毛建芬; 谢碧玉; 芮君; 黄永祥; 曹朝梁; 吴立群; 章赛军

    2012-01-01

    目的 探讨毒蛇咬伤抗蛇毒血清危机干预疗法的临床疗效.方法 2010年8月~2011年12月为前瞻性观察期,台州市中心医院急诊科实施血清危机干预治疗76例(干预组);2007年11月~2010年8月为历史对照期,实施蛇伤程序化救治139例(血清组),比较两组间的蛇伤种类、临床分型、住院天数、致残率、死亡率、好转率等.计数资料以率表示,采用χ2检验,计量资料以(x - ±s)表示,采用t 检验,以P<0.05为差异具有统计学意义.结果 干预组入院后治疗费用、并发症率明显高于血清组,差异均有统计学意义(P<0.05),两组入院后疗效评价如致残率、死亡率、好转率比较,差异均无统计学意义(P>0.05).结论 实施血清危机干预方案,缓解血清难求的局面,为健全急救药储备体系提供依据.%Objective To explore the clinical effect of snake antivenins crisis intervention therapy to snakebite. Methods An analysis was performed: a comparison was made between a collection of 76 cases of antivenins crisis intervention therapy which was used as the intervention group for prospective observation period in between August 2008 and December 2011 and the other collection of 139 cases of procedural serum therapy which served for historical control period between November 2007 and August 2008. The comparison made included snake bite species, clinical classification, length of hospital stay, disability and mortality, and recovery, and etc. The data was analyzed by adopting chi-square test, and expressed by the measurement of mean±SD and t-test, with P0.05). Conclusion Implementation of antivenins crisis intervention therapy was aimed to ease the situation of antivenins shortage, and provide as reference for emergency medicine system.

  4. Management of Tissue Loss After Agkistrodon Snakebite: Appropriate Use of Crotalidae-Fab Antivenin.

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    Larson, Kenneth W; Schaefer, Keith R; Austin, Cindy; Norton, Rhy; Finley, Phillip J

    2016-01-01

    Although initially created for the treatment of rattlesnake (genus: Crotalus) bites, Crotalidae-Fab antivenin is used to treat many different pit viper envenomations. However, the efficacy of Crotalidae-Fab in preventing tissue loss from copperhead (Agkistrodon contortrix) or cottonmouth (Agkistrodon piscivorus) snakebites remains unclear. Recent reports show that Agkistrodon-related bites rarely require treatment beyond simple observation and pain control. The purpose of this study was to examine the amount of tissue loss in patients who received Crotalidae-Fab compared with those who did not after an Agkistrodon bite. After institutional review board approval, a retrospective study was completed at a Level 1 trauma center. Between 2009 and 2013, a total of 57 snakebites were identified. Of the 57 bites, the snake species was documented in 36 cases including 31 copperheads, 1 cottonmouth, and 4 rattlesnakes. The other 21 bites were from unknown or nonvenomous species. Of the 32 Agkistrodon-related bites, 15 patients received Crotalidae-Fab (average of 3 vials administered) and 17 did not receive Crotalidae-Fab. None of the 32 patients, regardless of treatment option, had tissue loss or required surgical interventions. Only 1 patient received Crotalidae-Fab and debridement of a vesicle associated with the bite. No clinically significant differences were observed between the groups. These findings support previous literature that failed to show added benefit of Crotalidae-Fab treatment for Agkistrodon bites beyond patient comfort and pain control. Evaluation of current protocols for Agkistrodon envenomations is warranted. Snakebite wound education in trauma physicians and nurses may decrease unnecessary use of antivenom medication.

  5. Management of Tissue Loss After Agkistrodon Snakebite: Appropriate Use of Crotalidae-Fab Antivenin.

    Science.gov (United States)

    Larson, Kenneth W; Schaefer, Keith R; Austin, Cindy; Norton, Rhy; Finley, Phillip J

    2016-01-01

    Although initially created for the treatment of rattlesnake (genus: Crotalus) bites, Crotalidae-Fab antivenin is used to treat many different pit viper envenomations. However, the efficacy of Crotalidae-Fab in preventing tissue loss from copperhead (Agkistrodon contortrix) or cottonmouth (Agkistrodon piscivorus) snakebites remains unclear. Recent reports show that Agkistrodon-related bites rarely require treatment beyond simple observation and pain control. The purpose of this study was to examine the amount of tissue loss in patients who received Crotalidae-Fab compared with those who did not after an Agkistrodon bite. After institutional review board approval, a retrospective study was completed at a Level 1 trauma center. Between 2009 and 2013, a total of 57 snakebites were identified. Of the 57 bites, the snake species was documented in 36 cases including 31 copperheads, 1 cottonmouth, and 4 rattlesnakes. The other 21 bites were from unknown or nonvenomous species. Of the 32 Agkistrodon-related bites, 15 patients received Crotalidae-Fab (average of 3 vials administered) and 17 did not receive Crotalidae-Fab. None of the 32 patients, regardless of treatment option, had tissue loss or required surgical interventions. Only 1 patient received Crotalidae-Fab and debridement of a vesicle associated with the bite. No clinically significant differences were observed between the groups. These findings support previous literature that failed to show added benefit of Crotalidae-Fab treatment for Agkistrodon bites beyond patient comfort and pain control. Evaluation of current protocols for Agkistrodon envenomations is warranted. Snakebite wound education in trauma physicians and nurses may decrease unnecessary use of antivenom medication. PMID:27163225

  6. Comparación entre dos métodos de producción para la elaboración de antivenenos ofídicos Snake Antivenin: Comparison Between Two Production Methods

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    Adolfo Rafael de Roodt

    2010-06-01

    . Nevertheless, the treatment of venomous snakebites in domestic animals can turn diffcult due several problems among which, the conspicuous, is the low availability or lack of antivenoms for veterinary use. As commercial pressures on the pharmaceutical industry have led to a reduction in the production of antivenins in several parts of the world, their availability is sometimes rather limited and sometimes these products are impossible to obtain. In this work, we immunized horses with venom of South American vipers to obtain hyperimmune plasma. The plasma was processed to separate whole IgG of F(ab´2 fragments using two conventional methods (caprylic acid fractionation or double saline precipitation and pepsin digestion. The obtained antivenins were tested for their biochemical and immunochemical characteristics and neutralizing potency. The SDS-PAGE of the antivenins showed, in the processed antivenin, bands in the order of 150 and 100 kDa in the whole IgG or F(ab´2 fragments, respectively. The presence of albumin or contaminants of high or low molecular weight was not detected in any of the preparations. No important differences were observed in the neutralizing potency of the antivenins, although production cost was very low with the method used to obtain pure IgG. The low production cost makes the production of antivenins for veterinary use proftable when the production of F(ab´2 fragments is not possible.

  7. [Drug or plant substances which antagonize venoms or potentiate antivenins].

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    Chippaux, J P; Rakotonirina, V S; Rakotonirina, A; Dzikouk, G

    1997-01-01

    Dendroaspis jamesoni (Elapidae) and Echis oceliatus (Viperidae) are responsible for most of severe evenomation in Cameroon. Toxicity of venoms of these two species has been measured using mice according to the method of Spearman & Kàrber. The effect on experimental envenomation of various drugs (atropine, promethazine, neostigmine, hydrocortisone, pentosane sulfuric polyester, heparin, tranexamic acid and aminocaproic acid) and plant extracts (Schumanniophyton magnificum, Bidens pilosa, Securidaca longepedunculata and Garcinia lucida) has been observed associated or not with the antivenom lpser Afrique (SAV). The venom of D. jamesoni contains neurotoxins agonizing and antagonising acetylcholine. The toxicity of the venom did not depend on the route of injection. Atropine, promethazine, neostigmine and hydrocortisone protected animals against a venom dose up to 2 LD50. Moreover, atropine and promethazine potentiated the SAV. Similar results have been obtained with extracts from S. magnificum and B. pilosa. The venom of E. ocellatus induces haemorrhage and necrosis. The toxicity increased by 3-fold when the venom was injected through intravenous or intraperitoneal route, compared to intramuscular route. Pentosane sulfuric polyester and tranexamic acid protected mice against doses up to 3 LD50. Pentosane sulfuric polyester, hydrocortisone, heparin and aminocaproic acid increased the SAV protective titre by 50%. However, tried plant extracts weakly antagonised the venom and did not potentiate the SAV. PMID:9479470

  8. [Drug or plant substances which antagonize venoms or potentiate antivenins].

    Science.gov (United States)

    Chippaux, J P; Rakotonirina, V S; Rakotonirina, A; Dzikouk, G

    1997-01-01

    Dendroaspis jamesoni (Elapidae) and Echis oceliatus (Viperidae) are responsible for most of severe evenomation in Cameroon. Toxicity of venoms of these two species has been measured using mice according to the method of Spearman & Kàrber. The effect on experimental envenomation of various drugs (atropine, promethazine, neostigmine, hydrocortisone, pentosane sulfuric polyester, heparin, tranexamic acid and aminocaproic acid) and plant extracts (Schumanniophyton magnificum, Bidens pilosa, Securidaca longepedunculata and Garcinia lucida) has been observed associated or not with the antivenom lpser Afrique (SAV). The venom of D. jamesoni contains neurotoxins agonizing and antagonising acetylcholine. The toxicity of the venom did not depend on the route of injection. Atropine, promethazine, neostigmine and hydrocortisone protected animals against a venom dose up to 2 LD50. Moreover, atropine and promethazine potentiated the SAV. Similar results have been obtained with extracts from S. magnificum and B. pilosa. The venom of E. ocellatus induces haemorrhage and necrosis. The toxicity increased by 3-fold when the venom was injected through intravenous or intraperitoneal route, compared to intramuscular route. Pentosane sulfuric polyester and tranexamic acid protected mice against doses up to 3 LD50. Pentosane sulfuric polyester, hydrocortisone, heparin and aminocaproic acid increased the SAV protective titre by 50%. However, tried plant extracts weakly antagonised the venom and did not potentiate the SAV.

  9. [Effect of reduction in the Bothrops antivenin dose administrated in patients bitten by the Bothrops snake].

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    Jorge, M T; Ribeiro, L A

    1994-01-01

    Seven hundred and thirty accidents by Bothrops snake bite attended at Hospital Vital Brazil-Instituto Butantan (HVB-IB) were studied: 411 of in 1983/84 (group A) and 319 in 1986 (group B). All the patients were seen in the Hospital 6 hours after the bite. As an average, all the 411 patients of the group A and the 319 patients of the group B received antivenom capable of neutralizing 215 mg and 117 mg of Bothrops jararaca, respectively. Both groups were similar concerning to: sex and age of the patients; anatomic region bitten; frequency of incision and tourniquet use at the site bite; time in between of the accident and the admission at HVB-IB; classification of B. jararaca either young or adult; frequency of the coagulation impairment. There was no difference in the evolution of the local envenoming manifestations and there were no cases of death. PMID:8061698

  10. Preliminary evaluation of Vipera palaestinae snake bite treatment in accordance to the severity of the clinical syndrome.

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    Shemesh, I Y; Kristal, C; Langerman, L; Bourvin, A

    1998-06-01

    The intravenous administration of a 60 ml dose of Vipera palaestinae antivenin was the suggested standard treatment of every bitten patient. In this study 85 Vipera palaestinae bitten patients where selectively treated with antivenin depending on the severity of the clinical picture. Patients who developed systemic or severe local signs received 20 ml of antivenin over 30 min. If symptoms were still present, an additional 10 ml of antivenin was given until systemic signs subsided. Repeated doses of 10 ml of antivenin was administered in each case of systemic symptom relapse. 49% of patients did not exhibit any systemic symptoms and did not receive antivenin treatment. In 63% of antivenin treated cases symptoms were aborted by a single dose of 20 ml of antivenin. 23% of the antivenin treated patients needed 30-40 ml, 19 needed 50-60 ml and only 1 patient (2%) received 80 ml of drug. Serum sickness complications were found in 44% of antivenin treated patients. The results of this study show that antivenin treatment based on systemic symptoms is effective, required less antivenin than the treatment with fixed dose for each patient and reduces the incidence of serum sickness. PMID:9663693

  11. Funnel-web spider bite

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    ... monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound will be treated as appropriate. The person may receive: Antivenin, a medicine to ... available Breathing support, including oxygen, tube through the mouth into ...

  12. Scorpion anti-venom activity of botanicals: a pharmacological approach.

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    Dey, Abhijit; Dey, Amrita; De, Jitendra Nath

    2013-03-01

    Scorpion bite is considered as one of the common and dangerous phenomenon throughout the world. The clinical manifestations include pulmonary edema, myocardial damage, intracerebral haemorrhage, brachial plexopathy, renal failure etc. which sometimes leads to mortality. The common antivenin therapy includes anti-scorpion venom serum or prazosin. In the vast rural areas of the third world countries phytotherapy is considered as an alternative system of medicine and scorpion sting is treated with the help of medicinal botanicals. As the safety and efficacy are considered as important aspects of anti venin therapy, conventional treatment can be supported by the herbal remedy. The present review compiles a number of medicinal plants pharmacologically evaluated in vitro and/or in vivo for scorpion antivenin properties. Considering the aspects like cost effectiveness, availability, lesser side effects and development of drug resistance, plant based anti venin therapy may be considered as a possible remedy against scorpion envenomation. PMID:24175429

  13. Scorpion envenomation study in Behbahan County, Southwest Iran

    Institute of Scientific and Technical Information of China (English)

    Hamid Kassiri; Ali Kassiri; Mona Sharififard; Samaneh Shojaee; Masoud Lotfi; Elnaz Kasiri

    2014-01-01

    Objective:To study the incidence and epidemiology of scorpion sting cases that were referred to the health services centers of Behbahan County, Khuzistan Province, southwestern Iran, during the two yeare (2007-2008). Methods: In this descriptive retrospective research, the data has come from files of scorpion-stung patients referring to the health services centers of Behbahan during study period. A special scorpion sting sheet was prepared and completed for every case of scorpion sting. Analysis of 3441 case sheets received during this period was carried out. The frequencies of medical and entomo-epidemiologic parameters were turned to the percentage position. Results:A total of 3 441 cases of scorpion stings were reported during the two-year period from 2007 to 2008. The average incidence of scorpion stings was 8.8‰in the two years. The frequency of cases was higher during August, September, June and July that 2 056 cases of scorpion stings were reported. Most stings were occurred during summer. Nearly 51.3%of the cases were men. All cases had received antivenin. Majority of scorpion sting cases (56.5%) lived in the rural areas. The most common sting site was the hand. About 74.4%have received the antivenin 0-6 h after the sting. The early injection of the antivenin is very important. The most of the cases of scorpion stings (59%) were occurred by yellow scorpions. Conclusions: Surveillance for cases of scorpion stings must begin at all regions of Behbahan County. Treatment of cases of scorpion stings is conducted according to a protocol set by the Ministry of Health, Treatment and Medical Education. This protocol included directions for lines of treatment and the dose of antivenin recommended. Thereafter all cases are referred to hospital for further observation and management.

  14. The Related Risk Factors Analysis of Snake-Bite Induced Acute Kidney Injury.

    Science.gov (United States)

    Li, Wei; Chen, Fang; Wu, Shukun

    2016-01-01

    BACKGROUND The pathogenic mechanism of snake-bite induced acute kidney injury (AKI) remains unclear. Analyzing the risk factors for snake-bite induced AKI may provide the guidance needed for AKI prevention and early treatment. MATERIAL AND METHODS This retrospective study included 119 snake-bite patients who were hospitalized at the emergency department of Sichuan Provincial People's Hospital from January 2011 to September 2013. The patients were divided into AKI and non-AKI groups according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) guideline. Gender, age, and clinical examination data of the patients were recorded. The Mann-Whitney U test and Fisher exact test were performed to analyze the collected data; preliminary analysis of independent risk factors was performed with multivariate logistic regression. RESULTS Among the snake-bite patients, 98.3% were farmers. The mean age of patients was 46±12 years. Of the 119 patients (13.4%), 16 suffered from AKI. There were statistically significant differences between the AKI and non-AKI groups with respect to age, time interval from snake bite to antivenin therapy, creatine kinase, blood myoglobin, advanced age, regional lymphadenopathy, incision drainage, and hemoglobin. Preliminary analysis with multivariate logistic regression showed that advanced age and increased time interval from snake bite to antivenin therapy might be independent risk factors for snake-bite induced AKI. CONCLUSIONS Age, time interval from snake bite to antivenin therapy, creatine kinase, blood myoglobin, advanced age, regional lymphadenopathy, incision drainage, and hemoglobin were risk factors for snake-bite induced AKI. Advanced age and delayed antivenin therapy might be independent risk factors for snake-bite induced AKI. PMID:27377078

  15. Scorpion envenomation study in Behbahan County, Southwest Iran

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    Hamid Kassiri

    2014-05-01

    Full Text Available Objective: To study the incidence and epidemiology of scorpion sting cases that were referred to the health services centers of Behbahan County, Khuzistan Province, southwestern Iran, during the two yeare (2007-2008. Methods: In this descriptive retrospective research, the data has come from files of scorpionstung patients referring to the health services centers of Behbahan during study period. A special scorpion sting sheet was prepared and completed for every case of scorpion sting. Analysis of 3441 case sheets received during this period was carried out. The frequencies of medical and entomoepidemiologic parameters were turned to the percentage position. Results: A total of 3 441 cases of scorpion stings were reported during the two-year period from 2007 to 2008. The average incidence of scorpion stings was 8.8‰ in the two years. The frequency of cases was higher during August, September, June and July that 2 056 cases of scorpion stings were reported. Most stings were occurred during summer. Nearly 51.3% of the cases were men. All cases had received antivenin. Majority of scorpion sting cases (56.5% lived in the rural areas. The most common sting site was the hand. About 74.4% have received the antivenin 0-6 h after the sting. The early injection of the antivenin is very important. The most of the cases of scorpion stings (59% were occurred by yellow scorpions. Conclusions: Surveillance for cases of scorpion stings must begin at all regions of Behbahan County. Treatment of cases of scorpion stings is conducted according to a protocol set by the Ministry of Health, Treatment and Medical Education. This protocol included directions for lines of treatment and the dose of antivenin recommended. Thereafter all cases are referred to hospital for further observation and management.

  16. Stenosing flexor tenosynovitis following a rattlesnake bite.

    Science.gov (United States)

    Lee, Lydia; Yao, Jeffrey

    2010-07-01

    Snakebite victims have been described previously in orthopedic literature in regard to complications such as compartment syndrome and carpal tunnel syndrome. We introduce a previously unreported complication of stenosing flexor tenosynovitis in a patient bitten by a rattlesnake. After being bitten in her right forearm, the patient experienced mild systemic symptoms of fever and nausea and was assessed at an outside hospital, where it was determined that she did not suffer from envenomation and therefore did not require antivenin therapy. She presented to our institution 1 week later with signs and symptoms of acute, new-onset right thumb flexor tenosynovitis, with pain and tenderness at the level of the A1 pulley of the thumb, with intermittent triggering. She also presented the following week with ipsilateral carpal tunnel syndrome. The patient reported no such symptoms prior to the snakebite. Given the recent development of these conditions after her snakebite, in addition to her history of endocrine disorders, we believe that our patient suffered from envenomation that led to these complications. Nonoperative measures including splinting and steroid injections were taken, with mixed results, and surgical intervention was necessary. While the proper management of snakebites is controversial, especially in regard to the administration of antivenin, we believe our patient would have benefitted from immediate evaluation and consideration for antivenin. PMID:20608624

  17. Effects of the canine rattlesnake vaccine in moderate to severe cases of canine crotalid envenomation

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    Leonard MJ

    2014-10-01

    Full Text Available McGee J Leonard,1 Catherine Bresee,2 Andrew Cruikshank1 1Animal Specialty and Emergency Center, Los Angeles, CA, USA; 2The Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA Abstract: This is a retrospective multicenter study (2006–2012 examining a population of dogs with moderate to severe crotalid envenomation for protective effects of the canine rattlesnake vaccine. Five nonacademic emergency and referral veterinary hospitals in Southern California were involved in the study and contributed records regarding a total of 82 client-owned dogs that were treated for naturally occurring rattlesnake envenomation. All dogs received antivenin (Crotalidae polyvalent, with dosages ranging from one to three vials (mean: 1.3±0.6. Fourteen dogs (17% had a history of prior vaccination against crotalid venom. In univariate logistic regression modeling, cases with lower body weight (P=0.0001 or higher snakebite severity scores (P<0.0001 were associated with greater morbidity. No statistically significant difference in morbidity or mortality between vaccinated and unvaccinated dogs was found. The findings of this study did not identify a significantly protective effect of previous vaccination in the cases of moderate to severe rattlesnake envenomation that require treatment with antivenin. Keywords: rattlesnake envenomation, vaccine, antivenin, canine

  18. Indian common krait envenomation presenting as coma and hypertension: A case report and literature review

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    Arjun Datt Law

    2014-01-01

    Full Text Available Neuroparalytic snake bite is a common emergency situation encountered in India. Common krait (Bungarus caeruleus and cobra (Naja naja are important snakes causing neuroparalysis in North India. Despite severe neuroparalysis, patients who receive antivenin and ventilator support in time recover completely. Autonomic disturbances resulting in resting tachycardia, labile hypertension and sweating have been described in common krait envenomation. We present a case of common krait (B. caeruleus envenomation presenting in the locked-in state and severe hypertension that remained in such a state for over 96 h before a gradual and sustained recovery.

  19. Progress and improvement of the manufacturing process of snake antivenom

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    Zolfagharian H.

    2013-05-01

    Full Text Available Antivenoms have been used successfully for more than a century and up to now constitute the only effectivetreatment for snakebites .The production of antivenin started long time ago when the calmette was preparedthe antivenom in 1894.The method currently used to prepare antivenom by most of the manufacturers areoriginated from the method of Pope which was develop in 1938. Several new approaches in the production ofantivenom have been proposed to produce IgG, F(ab2, F(ab antivenin to improve their quality .Theseimprovement include complete or partial modification in the antivenom production regarding animal,immunization protocols , new adjuvants in hyperimmunization of animals , purification processes ( caprylicacid ,chromatography , diafiltration and ulterafiltration ,enzymatic digestion of IgG (pepsin, papain andfractionation of venom .When the IgG is digested enzymatically, different fragments are obtained depending on the enzyme used, that is, if papain is used, three fragments are obtained, the crystallizing fragment (Fc and two antigen-binding fragments F(ab and, if pepsin is used, one F(ab'2 fragment is obtained, while thecrystallizing fragment is digested. Fab and F(ab2 fragments conserve their capacity to specifically bind to the antigen that gave rise to them.

  20. [Accidents with venomous and poisonous animals in Central Europe].

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    Bodio, Mauro; Junghanss, Thomas

    2009-05-01

    Central Europe is largely safe from accidents with venomous and poisonous animals. The regions where European vipers are regularly found are shrinking. Today accidents with jellyfish and stings of venomous fish afflicted during leisure activities at the sea side play the dominant role. Life threatening accidents in Europe are mainly due to exotic snakes held in captivity. A system useful in daily medical practice is explained to classify and stage accidents due to poisonous and venomous animals. The important poisonous and venomous animals of Central Europe and the specific therapeutics, the antivenoms, are covered. The antivenom depot "Antivenin-CH" of the Swiss Toxicology Information Centre in Zurich and the MRITox in Munich with the antivenom registry Munich AntiVenom INdex (MAVIN) are presented.

  1. [Envenomation and poisoning by venomous or poisonous animals. VII: arachnidism in the New World].

    Science.gov (United States)

    Chippaux, J P; Alagón, A

    2008-06-01

    The incidence of scorpion stings and spider bites is high in Latin America. This is particularly true for Mexico, part of Amazonia, and southern and eastern Brazil. Centruroides and Tityus scorpion stings present a real danger for humans, especially children. Envenomation results in intense pain, neurological signs, and cardiorespiratory manifestations that can lead to death by acute pulmonary edema or heart failure. In the event of confirmed envenomation, antivenin must be administered as soon as possible in association with symptomatic treatment and, if necessary, cardiorespiratory resuscitation. Spider bites are a less frequent and severe. Envenomation by Loxosceles is extremely painful and necrotizing. Severe visceral complications can develop. An effective antivenim has recently become available for local and systemic envenomation. Envenomation by Latrodectus leads to neurological symptoms that can also be treated with antivenom. Envenomation by other spiders is less frequent and generally harmless.

  2. [Retrospective study on Latrodectus stings in Bahia, Brazil].

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    Lira-da-Silva, R M; Matos, G B; Sampaio, R O; Nunes, T B

    1995-01-01

    This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB). Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57%) affecting men (70%) more than women, with 10 to 29 year-old age group (58%). Local pain (56%), erythematous papula (29%) and light oedema (17%) were the principal local symptoms. Pain in the limbs (29%), tremor and rigidities (29%), sweating (28%), limbs and arms paresthesia (21%) and abdominal pain (17%) were systemic ones. The treatment was mainly symptomatic (67%) and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours.

  3. Clinical Aspects and Emergent Management of Snake Bites Presented to Emergency Department

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    Bedriye Sonmez

    2014-03-01

    Full Text Available Aim: Evaluating the epidemiologic characteristics and management of snake bites presenting to emergency departments. Material and Method: In this retrospective study 74 cases of snakebites admitted to Emergency Department of Diyarbakir Training and Research Hospital between 2008 and 2009 were retrospectively evaluated. Results: Fourty-six (62.2% of patients were male and 28 (37.8% were female. Mean age of the study population was 34.85±19.17 (min 7- max 80 years. Most of the snakebites occurred between 18.00 to 06.00 hours and at home (73%. 79.7% of snake bites occurred to upper extremities. %93 of cases had intravenous administration of antivenin (one dose. Neither none of the patients needed recurrent administration. Discussion: Snake bites are still a major public health problem especially in rural areas. Particularly emergency care physicians should be adequately capable and sophisticated in multidisciplinary management of snake bites.

  4. Accidente ofídico causado por Bothrops Asper

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    Galofre-Ruiz Mario David

    2013-12-01

    Full Text Available Introduction: The snake bite of the genus Bothrops is an important cause of ophidic accident in Colombia, with high morbidity and mortality. Clinical case: A case of bite by the snake Bothrops Asper, which was classified as mild grade of poisoning at the entrance of the hospital center is presented. It was managed with antiophidic serum in doses lower than the recommended one, with progression of the symptoms of poisoning. Adjustments in the doses were done and total recovery was reached in five days. Conclusions: Antiophidic serums, named also antivenins, are the cornerstone of the treatment to minimize the local tissue damage and the systemic complications. Rev. cienc.biomed. 2013;4(2:353-357

  5. Venomous snakebite in Thailand. I: Medically important snakes.

    Science.gov (United States)

    Chanhome, L; Cox, M J; Wilde, H; Jintakoon, P; Chaiyabutr, N; Sitprija, V

    1998-05-01

    Thailand has an abundance of venomous snakes. Among the neurotoxic family Elapidae, there are three species of the genus Naja (cobras), three of the genus Bungarus (kraits), and the king cobra of the genus Ophiophagus. Other Elapidae snakes in Thailand include sea snakes and Asian coral snakes of the genus Calliophis. They have potent venoms but rarely bite humans. Tissue and hemotoxic snakes are represented by family Viperidae, subfamilies Viperinae and Crotalinae. They remain an occupational hazard for farmers and rubber tappers, causing serious morbidity but only rare deaths, since competent treatment is now widely available throughout Thailand. Purified equine antivenin is manufactured locally for the monocled and Siamese spitting cobras (Naja kaouthia and N. siamensis), king cobra (Ophiophagus hannah), banded krait (Bungarus fasciatus), most green pit vipers (Trimeresurus sp.), Malayan pit viper (Calloselasma rhodostoma), and the Siamese Russell's viper (Daboia russelli siamensis).

  6. [Retrospective study on Latrodectus stings in Bahia, Brazil].

    Science.gov (United States)

    Lira-da-Silva, R M; Matos, G B; Sampaio, R O; Nunes, T B

    1995-01-01

    This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB). Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57%) affecting men (70%) more than women, with 10 to 29 year-old age group (58%). Local pain (56%), erythematous papula (29%) and light oedema (17%) were the principal local symptoms. Pain in the limbs (29%), tremor and rigidities (29%), sweating (28%), limbs and arms paresthesia (21%) and abdominal pain (17%) were systemic ones. The treatment was mainly symptomatic (67%) and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours. PMID:7480914

  7. The absence of antagonism between extracts of Clinacanthus nutans Burm. and Naja naja siamensis venom.

    Science.gov (United States)

    Cherdchu, C; Poopyruchpong, N; Adchariyasucha, R; Ratanabanangkoon, K

    1977-06-01

    Clinacanthus nutans Burm, a herb reputed in Thailand and Malaysia to be "snakebite antidote" has been tested in vitro and in vivo for antivenin activity. The aqueous extract of C. nutans leaves has been found to have no effect on the inhibition of neuromuscular transmission produced by purified Naja naja siamensis neurotoxin in isolated rat phrenic-nerve diaphragm preparations. The extract of C. nutans, when given orally or intraperitoneally, are ineffective in prolonging the survival time of experimental mice receiving lethal doses of N.n. siamensis crude venom. Oral administrations of the herb extracts pretreated with alpha-amylase or beta-amylase also fail to protect the animal. It is concluded that the extract of C. nutans can not antagonize the action of cobra venom. PMID:199949

  8. [Pulmonary embolism and disseminated intravascular coagulation after being bitten by a Bothrops lanceolatus snake. Apropos of a case].

    Science.gov (United States)

    Estrade, G; Garnier, D; Bernasconi, F; Donatien, Y

    1989-11-01

    The authors report the case of a Bothrops lanceolatus snake bite complicated by severe pulmonary embolism a few hours after admission. This thromboembolic complication developed despite heparin therapy and was followed by disseminated intravascular coagulation (DIC). Vascular thrombosis and pulmonary embolism are rare after Bothrops lanceolatus snake bite as patients are usually hypocoagulable due to DIC. In this case, the thromboembolism was probably caused by the procoagulant effect of the thrombin-like enzymes of the snake venom which may have been injected directly into the vein of a young woman taking a contraceptive pill. A specific antivenin which has recently become available fort treatment may decrease the complications of Bothrops lanceolatus snake bite. PMID:2514645

  9. Envenenamiento de Chelydra serpentina (Reptilia: Testudines por Tityus trivittatus (Scorpionida: Buthidae Envenomation of Chelydra serpentina (Reptilia: Testudines by Tityus trivittatus (Scorpionida: Buthidae

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    Adolfo R de Roodt

    2011-12-01

    Full Text Available Se describe el caso de un ejemplar de tortuga mordedora (Chelydra serpentina que fue hallada con los miembros tetanizados en extensión, midriasis y poca respuesta a estímulos externos, en cuyo recinto se encontró un ejemplar de escorpión Tityus trivittatus. Ante el claro cuadro de envenenamiento, se trató al quelonio con antiveneno escorpiónico específico retornando a un estado de relajación muscular a las seis horas y encontrándoselo totalmente normal a las 24 horas sin mostrar secuelas posteriores. Este es el primer comunicado sobre el envenenamiento de quelonios por escorpiones. Se discuten algunos aspectos de este envenenamiento escorpiónico y su tratamiento con antiveneno específico.We report the case of a snapping turtle (Chelydra serpentina found tetanized, with the limbs in extension, mydriasis and poor response to external stimuli, in whose terrarium was found a Tityus trivittatus scorpion. Based on the clear clinical picture of envenoming, the turtle was treated with a specific scorpion antivenin, returning to a state of muscle relaxation after six hours of treatment and it was found totally normal at 24 hours, without envenoming sequelae. This is the first report on turtle envenomation by scorpion. The scorpion envenomation in reptiles and the treatment with specific antivenom is discussed.

  10. Alleviation of viper venom induced platelet apoptosis by crocin (Crocus sativus): implications for thrombocytopenia in viper bites.

    Science.gov (United States)

    Santhosh, M Sebastin; Thushara, R M; Hemshekhar, M; Sunitha, K; Devaraja, S; Kemparaju, K; Girish, K S

    2013-11-01

    Viper envenomations are characterized by prominent local and systemic manifestations including hematological alterations. Snake venom metalloproteinases (SVMPs) and phospholipase A2 (PLA2) plays crucial role in the pathophysiology of hemorrhage by targeting/altering the platelets function which may result in thrombocytopenia. Platelets undergo the classic events of mitochondria-mediated apoptotic pathway due to augmented endogenous reactive oxygen species (ROS) levels. The observed anticoagulant effects during viper envenomations could be due to exacerbated platelet apoptosis and thrombocytopenia. Moreover, antivenin treatments are ineffective against the venom-induced oxidative stress; therefore, it necessitates an auxiliary therapy involving antioxidants which can effectively scavenge the endothelium-generated/endogenous ROS and protect the platelets. The present study explored the effects of viper venom on platelet apoptosis and its amelioration by a phytochemical crocin. The study evaluated the Vipera russelli venom-induced apoptotic events including endogenous ROS generation, intracellular Ca(2+) mobilization, mitochondrial membrane depolarization, cyt-c translocation, caspase activation and phosphatidylserine externalization which were effectively mitigated when the venom was pre-treated with crocin. The study highlights one of the less studied features of venom-induced secondary complications i.e. platelet apoptosis and sheds light on the underlying basis for venom-induced thrombocytopenia, systemic hemorrhage and in vivo anticoagulant effect.

  11. [Study on the venoms of the principal venomous snakes from French Guiana and the neutralization].

    Science.gov (United States)

    Estévez, J; Magaña, P; Chippaux, J P; Vidal, N; Mancilla, R; Paniagua, J F; de Roodt, A R

    2008-10-01

    We studied some biochemical, toxic and immunological characteristics of the venoms of Bothrops atrox, Bothrops brazili and Lachesis muta, Viperidae responsible for most of the bites of venomous snakes in French Guiana. Chromatographic (HPLC) and electrophoretical profiles (SDS-PAGE), lethal, hemorrhagic, defibrinogenating, coagulant, thrombin like, proteolytic, fibrino(geno)lytic and phospholipase activities were studied. In addition, the neutralization of some toxic activities conferred by four antivenins was compared. The chromatographic and electrophoretic profiles were different for the three venoms, showing differences between Bothrops and L. muta venoms. In general, bothropic venoms showed the highest toxic and enzymatic activities, while the venom of L. muta showed the lowest lethal, hemorrhagic and coagulant activities. The enzymes of bothropic venoms responsible for gelatinolytic activity were around 50-90 kDa. All the venoms were able to hydrolyze a and beta chains of the fibrinogen, showing different patterns of degradation. Although all the antivenoms tested were effective to various degrees in neutralizing the venom of B. brazili and B. atrox, neutralization of L. muta venom was significantly better achieved using the antivenom including this venom in its immunogenic mixture. For the neutralization of L. muta venom, homologous or polyvalent antivenoms that include the "bushmaster" venom in their immunogenic mixture should be preferred. PMID:18956820

  12. Aspectos epidemiológicos e clínicos dos acidentes ofídicos ocorridos nos municípios do Estado do Amazonas Epidemiological and clinical aspects of snake accidentes in the municipalities of the State of Amazonas, Brazil

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    Célio Campos Borges

    1999-12-01

    municipality (70.2%. The local signs and symptoms most frequently observed in those who received medical care more than 6 hours after the accident (57.3% were edema (76.9%, pain (68.7%, erithema (10.2% and hemorrhage (9.3%. The systemic manifestation most frequently observed was hemorrhage (18.8%. Serotherapy was administered in only 65.9% of patients, the intravenous route being the route most commonly used to administer the antivenin (52.3%, while other non- recommended routes were widely used. In the majority of patients the antivenin given was antibotropic. The most frequent complications were: abscess 13.7%, necrosis 12.3%, secondary infection 8.3%, renal insufficiency 2.5% and gangrene 2.5%. The medical procedures most used in the treatment of these complications were drainage 52.6%, debridement 28.9%, amputation 10.5%, surgical cleaning 5.3% and peritoneal dialysis 2.6%. The fatality rate was 1%.

  13. Estudo retrospectivo de latrodectismo na Bahia, Brasil

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    Rejâne Maria Lira-da-Silva

    1995-09-01

    Full Text Available O trabalho apresenta um estudo retrospectivo de setenta e sete casos de latrodectismo no Estado da Bahia, Brasil, de agosto de 1980 a julho de 1990. Os dados foram levantados nos livros de registro e arquivo de fichas do CIAVE. O agente etiológico em 28% dos acidentes aracnídeos foi a espécie L. curacaviensis e a maior incidência foi registrada no meio urbano (57%, em indivíduos do sexo masculino (70% e faixa etária de 10 a 29 anos (58%. Os principais sinais locais foram dor (56%, pápula eritematosa (21% e edema discreto (17%, e os sistêmicos foram dor em membros inferiores (29%, tremores e contraturas (29%, sudorese (28% parestesia em membros (21% e dor abdominal (17%. O tratamento foi sintomático em 67% dos casos e específico em 21%. O tempo de permanência hospitalar após o uso do soro antilatrodectus foi menor que 24 horas em 64% dos casos.This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB. Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57% affecting men (70% more than women, with 10 to 29year-old age group (58%. Local pain (56%, erythematous papula (29% and light oedema (17% were the principal local symptoms. Pain in the limbs (29%, tremor and rigidities (29%, sweating (28%, limbs and arms paresthesia (21% and abdominal pain (17% were systemic ones. The treatment was mainly symptomatic (67% and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours.

  14. Antihaemolytic and snake venom neutralizing effect of some Indian medicinal plants

    Institute of Scientific and Technical Information of China (English)

    Chidambaram Kumarapppan; Albert Jaswanth; Karpagam Kumarasunderi

    2011-01-01

    Objective:To validate traditional claims of usefulness of the Indian plants in management of poisonous snakebite and evaluate the antivenom properties displayed by the alcoholic extracts ofAndrographis paniculata (A. paniculata),Crateva magna (C. magna),Gloriosa superba (G. superba) andHydrocotyle javanica (H. javanica).Methods:These plants were collected, identified and the extracts were prepared by using conventional Soxhlet ethanol extraction technique. The venom neutralization activity was accessed in mice (20-25g) and number of mortalities was observed against clinically important snake (Naja nigricollis) venom. Present study also deals with in vitro membrane stabilizing activity of these plants against hyposaline induced human red blood corpuscles(HRBC).Results: Extracts ofH. javanica andG. superba gave80 % and90 %protection to mice treated with minimum lethal dose of venom (LD99). These two plants showed significant neutralization effect against the venoms of Naja nigricollis venom.H. javanica andG. superba(25-100 mg/mL) produced significant changes of membrane stabilization of human red blood cells(HRBC)exposed to hyposaline-induced haemolysis.Conclusions:We conclude that probably due to presence of various phytochemicals plays an important role in the anti-venom potential of these Indian medicinal plants against Naja nigricollis venom. The above observations confirmed thatA. paniculata, C. magna, G. superba andH. javanica plant extracts possess potent snake venom neutralizing capacity and could potentially be used as an adjuvants for antivenin therapy in case of snakebite envenomation, especially against the local effects of cobra venoms.

  15. An Important Ethnomedicinal Plant Balanite Aegyptiaca Del.

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    Shweta Suresh Saboo

    2014-06-01

    Full Text Available For centuries traditional medical systems (TMS were the primary medical system in the countries of origin, and now nevertheless the present dominance of the Western scientific medical model, citizens and health-caregivers are starting to rely and trust TMS. The usage of herbs to treat a variety of different ailments is universal, and exists in every human culture on Earth different Ethno medicinally important plant are available in our surrounding which having lot’s of medicinal importance .in this paper we are focusing on importance of  Balanites aegyptiaca Del., also known as ‘Desert date’ Synonyms: Ximenia aegyptiaca L. family Zygophyllace,. Balanites aegyptiaca Del Ethnobotinical it’s reported as a good  jaundice, intestinal worm infection, wounds, malaria, syphilis, epilepsy, dysentery, constipation, diarrhea, hemorrhoid, stomach aches, asthma, and fever It is distributed tropical areas,  Balanites aegyptiaca Del manly cultivated by seedling and propagation. In this paper we are also discussing about morphological character of Leaves, Flowers , Habit  , Diagnostic characters .chemically also it’s very enriched plant the number of Chemical constituents like protein, lipid, carbohydrate, alkaloid, saponin, flavonoid, and organic acid quercetin-3-rutinoside;furanocoumarin bergapten and dihydrofuranocumarin D- marmesin, ,  beta-sitosterol, bergapten, marmesin, and beta-sitosterol glucoside,balanitin-1,-2, and -3 , Balanitoside yamogenin, scientifically this plant is reported as good Anthelmintic activity, Antibacterial activity, Antivenin activity, Anticancer activity Anti-inflammatory and analgesic activity, In vitro antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities, antinociceptive , Antidiabetic activity Antiviral activity Wound healing activity, Hypocholesterolemic activity, Diuretic activity.

  16. Scorpion stings in Turkey: epidemiological and clinical aspects between the years 1995 and 2004 Picadas de escorpião na Turquia: aspectos epidemiológicos e clínicos entre os anos de 1995 e 2004

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    Yıldırım Cesaretli

    2010-08-01

    Full Text Available The most important health-threatening scorpions found in Turkey are; Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus and M. eupeus species, all of which belong to the Buthidae family. The epidemiological and clinical findings of scorpion stings in Turkey were evaluated between the years 1995 and 2004 based on data recorded in the National Poison Information Center (NPIC. A total of 930 cases were recorded. The cases mostly occurred in the month of July. The gender distribution was 50.22% female and 45.48% male. It was shown that the 20-29 age group presented more scorpion stings. Most of the stings occurred in Central Anatolia and Marmara regions of Turkey. Patients at the hospital showed signs of localized (pain, hyperemia, edema and numbness and systemic effects (hyperthermia, nausea and vomiting, tachycardia, shivering and lethargy but no lethality was notified. According to records, 33% of the poisoned patients were treated with antivenin in healthcare facilities.Os mais importantes escorpiões que comprometem a saúde na Turquia são: Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus e M. eupeus, todos eles pertencentes à família Buthidae. Os achados clínicos e epidemiológicos da picada de escorpiões na Turquia foram avaliados no período entre os anos de 1995 a 2004 baseados em dados do Centro Nacional de Informações de Envenenamentos (NPIC. Foram registrados 930 casos que ocorreram principalmente no mês de julho. A distribuição por sexo foi 50,22% femininos e 45,48% masculinos. Demonstrou-se que o grupo etário de 20 a 29 anos apresentou maior número de picadas de escorpião. A maior parte das picadas ocorreu na Anatólia Central e na região de Marmara, na Turquia. Os pacientes hospitalizados mostraram sinais localizados (dor, hiperemia, edema e confusão mental e sistêmicos (hipertermia, náusea e vômitos, taquicardia, arrepios de frio e letargia, mas não houve notificação de

  17. Mechanisms involved in the nociception triggered by the venom of the armed spider Phoneutria nigriventer.

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    Camila Gewehr

    Full Text Available BACKGROUND: The frequency of accidental spider bites in Brazil is growing, and poisoning due to bites from the spider genus Phoneutria nigriventer is the second most frequent source of such accidents. Intense local pain is the major symptom reported after bites of P. nigriventer, although the mechanisms involved are still poorly understood. Therefore, the aim of this study was to identify the mechanisms involved in nociception triggered by the venom of Phoneutria nigriventer (PNV. METHODOLOGY/PRINCIPAL FINDINGS: Twenty microliters of PNV or PBS was injected into the mouse paw (intraplantar, i.pl.. The time spent licking the injected paw was considered indicative of the level of nociception. I.pl. injection of PNV produced spontaneous nociception, which was reduced by arachnid antivenin (ArAv, local anaesthetics, opioids, acetaminophen and dipyrone, but not indomethacin. Boiling or dialysing the venom reduced the nociception induced by the venom. PNV-induced nociception is not dependent on glutamate or histamine receptors or on mast cell degranulation, but it is mediated by the stimulation of sensory fibres that contain serotonin 4 (5-HT4 and vanilloid receptors (TRPV1. We detected a kallikrein-like kinin-generating enzyme activity in tissue treated with PNV, which also contributes to nociception. Inhibition of enzymatic activity or administration of a receptor antagonist for kinin B2 was able to inhibit the nociception induced by PNV. PNV nociception was also reduced by the blockade of tetrodotoxin-sensitive Na(+ channels, acid-sensitive ion channels (ASIC and TRPV1 receptors. CONCLUSION/SIGNIFICANCE: Results suggest that both low- and high-molecular-weight toxins of PNV produce spontaneous nociception through direct or indirect action of kinin B2, TRPV1, 5-HT4 or ASIC receptors and voltage-dependent sodium channels present in sensory neurons but not in mast cells. Understanding the mechanisms involved in nociception caused by PNV are of

  18. Chang of nuclear factor-κappa B activation in peripheral blood mononuclear cells in the patients bitten by agkistrodon halys and its clinical significance%蝮蛇伤患者外周血单核细胞核因子-κB活性的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    邓立普; 李桂花; 田中秋; 周克兵; 贺承健; 任中强; 何香华; 陈莉

    2011-01-01

    criteria: MODS group and non - MODS group. In accordance to the time of agkistrodon antivenins, the patients were divided into pre - intervention, 6 h after the intervention, 24 h after the intervention group. Blood samples of all the patients were collected on admission without any intervention, at 6 h after giving anti -agkistrodon venom serum, 24 h after the intervention. The activity of NF - κB was measured by enzyme- linked immunosorbent assay in peripheral blood mononuclear cells, the difference of the activity of NF - κB was compared respectively. 30 healthy people were regarded as control group.Results There were significant differences in NF - κB levels between mild, severe and critical type respectively( P < 0.05 ). Compared with control group, there was significant difference in NF - κB levels among 3 groups of different types( P < 0.05). There was significant difference between SIRS group and non- SIRS group( t =4.05 ,P < 0.05 ), between MODS group and non- MODS group( t = 4.60, P <0. 05 ). Pairwise comparisons of different intervention time groups had significant difference in NF - κB levels(P < 0.05). Conclusion Venomin can activate NF - κB, the activation of NF - κB participates in the onset and development of pathogenetic condition in patients bitten by agkistrodon halys possibly.The occurrence of SIRS and MODS are clearly associated with activation of NF - κB in the patients bitten by agkistrodon halys.