by Bushviper » Wed Dec 05, 2012 3:15 pm
Best I can do :
Title
Clinical features of twig snake (Thelotornis capensis) envenomation.
Authors
ATKINSON, P. M.; BRADLOW, B. A.; WHITE, J. A. M.; GREIG, H. B. W.; GAILLARD, M. C.
Journal
South African Medical Journal 1980 Vol. 58 No. 25 pp. 1007-1011
ISSN
0038-2469
Record Number
19812902192
Abstract
While trying to catch a twig snake in South Africa, a 13-year-old boy was bitten on the finger. 5 h after the bite the bleeding time was found to be prolonged and the blood was incoagulable. 400 ml of freeze-dried plasma failed to restore blood coagulability and haemostasis became progressively more abnormal up to 112 h after admission. Prothrombin, kaolin partial thromboplastin and thrombin times were prolonged, platelet count fell to 21 000 per mm3, the fibrinogen titre fell to 1 in 4, and levels of fibrinogen degradation products were elevated in the serum. No bleeding was detected and the patient was discharged from hospital on the sixth day when his platelet count had almost returned to normal. Venom gland extract from 3 specimens of Thelotornis capensis were studied in vitro. Purified human prothrombin was cleaved in the same positions as by boomslang (Dispholidus typus) venom and there was also evidence of factor X activation. Boomslang antivenom failed to block the procoagulant action of twig snake venom. In the absence of an antivenom with specific or paraspecific activity, the authors suggest transfusion of fresh plasma and platelets. Heparin is not recommended.
[At least 9 cases of bites by the 2 subspecies Thelotornis kirtlandii capensis and T. k. kirtlandii have now been reported with 2 fatalities. All bites resulted from the snakes being handled carelessly by people who were unaware of the danger of severe envenoming. The venom gland extract of this snake has been studied previously (KORNALÏK et al., Toxicon, 1978, 16, 535) with slightly different results. The procoagulant appears to be one of the most potent found in snake venoms.] David A. Worrell.
It is easier to ask for forgiveness than permission.
Those who are afraid to ask are ashamed of learning.