Differential diagnosis between venomous (Bothrops jararaca, Serpentes, Viperidae) and “Nonvenomous” (Philodryas olfersii, Serpentes, Dipsadidae) snakebites: is it always possible?

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dc.contributorLaboratório de Ecologia e Evoluçãopt_BR
dc.contributorLaboratório de Coleções Zoológicaspt_BR
dc.contributorHVB - Hospital Vital Brazilpt_BR
dc.contributor.authorMedeiros, Carlos Roberto dept_BR
dc.contributor.authorDuarte, Marcelo Ribeiropt_BR
dc.contributor.authorSouza, Solange Nogueira dept_BR
dc.date.accessioned2021-10-22T18:07:12Z-
dc.date.available2021-10-22T18:07:12Z-
dc.date.issued2021pt_BR
dc.identifier.citationMedeiros CR, Duarte MR, Souza SN. Differential diagnosis between venomous (Bothrops jararaca, Serpentes, Viperidae) and “Nonvenomous” (Philodryas olfersii, Serpentes, Dipsadidae) snakebites: is it always possible?. Wilderness Environ. Med.. 2021 Dec;32(4):522-527. doi:10.1016/j.wem.2021.07.009.pt_BR
dc.identifier.urihttps://repositorio.butantan.gov.br/handle/butantan/3958-
dc.description.abstractBites of “nonvenomous” snakes can sometimes be mistaken for the bites of venomous snakes. As an example of this confusion, this report describes confirmed bites by Philodryas olfersii and Bothrops jararaca. In the first case, a 55-y-old man with a history of controlled hypertension was bitten on his right forearm by P olfersii. Physical examination revealed extensive edema, erythema, and widespread ecchymoses throughout his right upper limb. Laboratory tests indicated leukocytosis and high D-dimer levels, but normal coagulation, suggestive of a resolved recent coagulopathy. He received only supportive treatment. In the second case, a healthy 35-y-old man was bitten by B jararaca. Although the anatomic region of the bite and the results of physical examination were similar to those in the first case, laboratory tests showed mild coagulopathy, leukocytosis, and high D-dimer levels. The patient was treated with antivenom. In both cases, the 20-min whole blood clotting test results were normal. Patients bitten by P olfersii may present with local symptoms resembling B jararaca envenomation. Without snake identification and the detection of venom-induced consumption coagulopathy, especially in places where the 20-min whole blood clotting test is the only clotting test available, it is almost impossible to establish an accurate and safe differential diagnosis. In this context, the best alternative is to take the risk of prescribing antivenom for a possible P olfersii bite rather than failing to do so for a real Bothrops bite. Late treatment for Bothrops bite can result in severe complications and sequelae.pt_BR
dc.format.extent522-527pt_BR
dc.language.isoEnglishpt_BR
dc.relation.ispartofWilderness & Environmental Medicinept_BR
dc.rightsRestricted accesspt_BR
dc.titleDifferential diagnosis between venomous (Bothrops jararaca, Serpentes, Viperidae) and “Nonvenomous” (Philodryas olfersii, Serpentes, Dipsadidae) snakebites: is it always possible?pt_BR
dc.typeArticlept_BR
dc.identifier.doi10.1016/j.wem.2021.07.009pt_BR
dc.identifier.urlhttps://doi.org/10.1016/j.wem.2021.07.009pt_BR
dc.contributor.external(USP) Universidade de São Paulopt_BR
dc.contributor.externalCentro Universitário São Camilopt_BR
dc.identifier.citationvolume32pt_BR
dc.identifier.citationissue4pt_BR
dc.subject.keywordnon-front-fanged colubroidspt_BR
dc.subject.keywordnonvenomous snakept_BR
dc.subject.keywordantivenompt_BR
dc.relation.ispartofabbreviatedWilderness Environ. Med.pt_BR
dc.identifier.citationabntv. 32, n. 4, p. 522-527, dez. 2021pt_BR
dc.identifier.citationvancouver2021 Dec;32(4):522-527pt_BR
dc.contributor.butantanMedeiros, Carlos Roberto de|:Pesquisador|:Laboratório de Ecologia e Evolução|:PrimeiroAutor:Autor de correspondênciapt_BR
dc.contributor.butantanDuarte, Marcelo Ribeiro|:Técnico|:Laboratório de Coleções Zoológicaspt_BR
dc.contributor.butantanSolange Nogueira de Souza|:Pesquisador|:HVB - Hospital Vital Brazilpt_BR
dc.identifier.bvsccBR78.1pt_BR
dc.identifier.bvsdbIBProdpt_BR
dc.description.dbindexedYespt_BR
item.grantfulltextembargo_29990101-
item.languageiso639-1English-
item.openairetypeArticle-
item.fulltextCom Texto completo-
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crisitem.author.orcid0000-0001-9533-0819-
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