Full text

 

 

J. Venom. Anim. Toxins incl. Trop. Dis.

V.20, 2014.

Review article - ISSN 1678-9199.

 

Hump-nosed viper bite: an important but under-recognized cause of systemic envenoming

 
Mitrakrishnan Chrishan Shivanthan1*, Jevon Yudhishdran2, Rayno Navinan2, Senaka Rajapakse3

 

1University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka

2Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka

3Department of Clinical Medicine, and project lead, Tropical Medicine Research Unit, University of Colombo, Colombo, Sri Lanka

 

ABSTRACT

Hump-nosed viper bites are common in the Indian subcontinent. In the past, hump-nosed vipers (Hypnale species) were considered moderately venomous snakes whose bites result mainly in local envenoming. However, a variety of severe local effects, hemostatic dysfunction, microangiopathic hemolysis, kidney injury and death have been reported following envenoming byHypnale species. We systematically reviewed the medical literature on the epidemiology, toxin profile, diagnosis, and clinical, laboratory and postmortem features of hump-nosed viper envenoming, and highlight the need for development of an effective antivenom.

 

Key words: Hypnale; Hump-nosed viper; Envenoming; Viper; Venom; Antivenom

 

Received: February 13, 2014; Revised: May 30, 2014; Accepted: June 6, 2014

 

Corresponding author: Mitrakrishnan C Shivanthan mcs627@gmail.com

 

Competing interests

The authors declare that there are no competing interests.

 

Authors' information

MCS and MJY are senior specialist registrars, and MRN is a specialist registrar at the National Hospital, Colombo, Sri Lanka. SR is a professor and consultant physician, Department of Clinical Medicine, and project lead, Tropical Medicine Research Unit, University of Colombo, Sri Lanka.

 

Authors’ contributions

MCS and SR conceived the review. MCS, MJY and MRN performed the initial literature search. MCS and SR independently read through the abstracts, selected relevant papers, and read through the full texts. MCS, MJY and SR extracted data. MCS wrote the first draft. SR and MRN critically reviewed and revised the manuscript. All authors read and approved the final manuscript.