human envenomation by an aglyphous colubrid snake, liophis miliaris
Transcription
human envenomation by an aglyphous colubrid snake, liophis miliaris
15 3 Cuad. herpero L. 14 (2 ): 15 3-1 54. 200 1 (2000) HUMAN ENVENOMATION BY AN AGLYPHOUS COLUBRID SNAKE, LIOPHIS MILIARIS (LINNAEUS, 1758) M ARÍA CRI STI NA DOS S ANTOS- COSTA & MARCOS D r-B ER NA RDO Loborotóri" de Herpetolog io. i\l uséu de Ci~ncio s e T ec nolog ia. POllt ifícia Univers idade Cat ól ica do Río Grande do S u!. Av. Ipíranga. 668 1. CEP 906 19-900 . Pono Alegre. Río Gra nde do Su!' Brazí!. E-maí l: mccosra@pucrs.br / madibe @pucrs.br In Braz il. so me snake s of the fa mily Colubri dae. usuall y regarded as not venomous, are respo nsable by serious and even so fatal acci dent s. Some op ist hoglyphous snakes th at occur in so uth ern Brazil. as Philodrm s olfersii (Li c ht enstei n. 1823) . Bo iru na lI1 acula ra (Boulenge r. 1896). Phalorris lell1nisca rllslri/ineaTus Boul enger. 1889 and Thal17n odynastes srrigaTlIs (GÜn ther. 1858) deserve greatest attenti on because they have already caused human envenomation as reported by many authors (Hoge. 1952 ; Lema. 1978a; Salomao & Di-Bernardo. 1995; Santo s-Cos ta et al .. in press) . There is at leasl one record of a fatal aceident ca used by Ph ilodrms olfersii (Salomao & DiBe rn ardo . 1995 ) and many or her records of se ri ous acci dent s. with th e patie nts showin g edema. pain and enlarged ax illary lymp h nodes (Nickerson & Henderson. 1976; Sil va & Buononato. 1984: Dav id & Ineich. 1999). Phalotris le/11niscatlls Iri/in eallls. a fo ssoria l snake, dese rves attention by the gravi ty 01' its envenomali on. which may causes hemorrhagic maniI'estati ons. local pain, pares thesia and acute renal fai lu re (Lem a, 1978b). Accidents by aglyphous snakes are liule repon ed. Some spec ies may cause hi gh-gravi ty envenomations. li ke Rhabdophis rigrinus (Boie, 1826). Thi s snake has very tox ic venom that ac ts directl y on prothrombin time, provoking hemorrh ag ic manifestatio ns and blood coag ulat ion disorders. In Japan some deadl y cases we re registered (Mitt lema n & Goris, 1976; Ogawa & Saw ai, 1986; David & Ineich, J 999). Seib ( 1980) suffered an acc ident by Uroth eca elap oides (Cope. 1860) and presented intense local pain fo ll owed by ecchimos is and inflammation of the axi ll ary Iym ph nodes. He was sucéessfull y treated wit h anti-Crotalus serum. At 20h 40min of November 4 th , 1996, in the Mun ici pali ty of Capin zal, State of Santa Catarina, Brazil, the junior author (33 years old, 1.76 m hi gh, 71 kg weight) was bitten in the fifth fin ger of the right hand while capturing aj uveni le Liophis miliaris (Linnaeus, 1758) (27 ,45g; 472 ,0 mm total length ; housed in Mu seu de Ciencias e Tecnologia da PUCRS under number MCP 7763). While biting, the snake ehewed se veral ti mes, re leas in g after few seco nd s. Subsequentl y there was intense local bleed ing and, three min utes later, edema, first on finger and progress ively expandi ng to the enti re hand and wri st, wi th intense itching, local pain and paresthesia, the latter on the right side of the hand. Thi s proeess continued fo r 40 minu tes , evolvin g to the cure without treatment. The paresthes ia and edema reported in thi s case are probably consequences of the proteoIytic properties of the sali va. Experiments testing extracts of oral glands of the aglyphous SibJ l1 om orphus n euwiedi (Iherin g, 1910) showed proteolytic acti vity on casein ; thj s same ex tract, inocul ated in rats and slugs, occasioned change of behaviour and paralysis (Laporta-Ferreira & Salomao , 199 1). The intense local bleeding here reported was also accounted, regarding accidents by Rhab dop his tig rinus tigrinus (Sakai et al. , 1990). Although the patients menti oned in that report suffe red serio us blood coagulation di sorders, thi s fact was not observed in the present case. Little is known on the cherrucal nature of the Notas & Novedades zoogeográ fi cas sa li va 0 1' ag lyphou s snakes . and w hat lO do in lhe prese nee of aee ide nts with sig ns 01' e nveno mali o n. We propose a re valu ati o n 01' the eonce pl s re laled to e nven o mati o ns ca used by sna kes gene rieally called ' not ve no mo us', and inlc nd to ale rt profess io nals 01' the hea lth area abo ul lhe necess ily o f atte ndin g carefull y accide nl S invo lving these anim als. A CK.!'10WLEDGM ENTS W e a re g rate ful lo Marci o B o rges Martin s, Ro na ldo Fe rn andes and P atri c k David ro r sugge sli o ns and correclion s o n the dra rl manu sc ri pt. Th e co ntract eS labli s hed be twee n lh e Mu scu de Ci e nci as e Tecnol og ia da PUCRS and E LETROS U L prov id ed lh e o ppo rtunity for condu c tin g lhe fi e ld slud y o n w hi e h lhi s re po rt was based. CITED LITERATURE DA VID , P. & I. INEICH . 1999. Les se rpe nts veni me ux du mo nde: sys té malique e t répartiti o n. DUlI1erilia 3:3-499. HOGE. A. R. 1952 . R ev alid ac;ao de T/w mllodylIastes strigatus (G ünthe r, 1858). Mem. IlI st. Buta ntall 24(2): 15 7-1 72. LAPORTA-FERREIRA , LL. & M .G. S ALOM AO . 199 1. M o rpho logy , Ph ys io logy and Tox ico logy of the Oral G land o f a Tropi ca l Coc hleoph ago us S nake, Siby11 0 111 o rp/lIIs lIeuwiedi (Co lubrid ae - Dipsadin ae) . Zool. A ll z . 227 : 198-208. LE M A , T. 1978a. Cobras nao venenosas qu e matam. Na tu reza ell1 re vista 4:38 -46 . _ _ o 1978b. Re lato de um envene name nlo po r uma cobra nao ve nenosa. NalUrez.a em Rec ihido: 08/0 812000 Acc plauo: 08/ 1 112000 revista 4:62-63 . MITTLEMAN , M.B. & R .e. GORIS . 1976. Death ca used by the bite of the Japanese co lubrid snake Rhabdophis tig rinus (Boie). 1. Herpetol. 12( 1) : 108-109. NICKERSON , M.A. & R.W. HENDERSON. 1976. A case 01' e nve nomati o n by th e So ulh Am e rican colubrid , Philodryas olfersii. Herpetologica 32 : 197-1 98. OGA W A , H . & Y. SA W AL 1986. F atal bile o f the Yamakagashi (Rhabdophis tigrinlls) . Th e SlIake 18: 53-54 . SAKAI, A. ; M. HATSUSE& y. SAWAY. 1990. Sludy on the pathogenes is of enve no mation by lhe Japanese colubrid sna ke, Y amakag ashi , Rhabdophis tigrinus tigrinli S - 4 . He mato log ical and hi slo log ica l studi es. Th e Snake 22 : 11-1 9. SALOMAO. E.L. & M . DI-BERN ARDO . 1995. Philodryas o(fersii: um a cobra co mum que mala. Caso reg istrado na área da 8' De legacia Reg ion al de Saúde . A rquivos da SBZ 14/1 5/16: 2 1. SANTOS-COSTA , M.C: OUTEfRAL, A .B .; D ' AG OSTINI, F.M. & C APPELLARf, L.H . ( IN PR ESS) . Enve no mati o n by lh e Neotro pi ca l co lubrid Boirul/a mandata (Bo ul e nger, 1896 ): a case re po rt o Rev. In st. M ed. Trop. Süo Paulo. SEIB , R.L. 1980 . Hum an enveno mati o n fro m the bite oCan ag lyphous false coral snake, Pliocercus elapoides (Se rpentes: Co lubridae). Toxicol/ 18:399-40 l . SILVA , M .V . & M .A. BU ONONATO. 1984 . Re lato clíni co de envenenamento hum ano po r Philodryas olfersii . M em . II/s t. Bulantal/ 47/48 : 12 1-1 26.