Serpents exotiques en Europe: Un cas de morsure par Mocassin du Mexique (Agkistrodon bilineatus)

Translated title of the contribution: Exotic snakes in Europe: A case of Mexican Moccasin (Agkistrodon bilineatus) snakebite

Davide Lonati, Raffaella Butera, Mauro Cima, Susanna Cozzio, Carlo Locatelli, Luigi Manzo

Research output: Contribution to journalArticlepeer-review


Introduction: In the last years exotic snakebite envenomations are increasingly reported. These cases are difficult to manage because of the limited experience of European physicians in the treatment of bites from such venomous snakes; moreover, specific antivenoms are unevenly stocked and they are difficult to find in case of a medical emergency. Observation: A 39-year-old herpetologist was bitten in his right hand by a mexican moccasin (Agkistrodon bilineatus) at the workplace, and presented in the Emergency Department 19 hours later. At admission, clinical evaluation showed local necrosis, swelling involving the entire limb up to the trunk, and severe pain. The specific antidote, not stocked in Italy, was sought abroad; its finding and routeing up to spot delivery required 12 hours. The antivenom, given 32 hours after the bite with no adverse reactions, was only partially effective. The clinical course was characterized by extensive edema with rhabdomyolysis. The necrotic wound at the bite site required after several days surgical débridement, and eventually skin graft. At 3 months follow-up, motor impairment of his right hand fingers with functional disability was still present. Comments: The envenomation by Agkistrodon bilineatus has some clinical aspects in common with that by European viper species, although crotalìd venom usually causes more severe manifestations. The antivenom supply from a foreign country may delay its administration. A specific legislation aimed to simplify antidotes importing procedures for professional snake handlers may improve antivenoms availability and allow their timely use, as soon as clinically indicated.

Translated title of the contributionExotic snakes in Europe: A case of Mexican Moccasin (Agkistrodon bilineatus) snakebite
Original languageFrench
Pages (from-to)1582-1584
Number of pages3
JournalPresse medicale (Paris, France : 1983)
Issue number22
Publication statusPublished - Dec 18 2004

ASJC Scopus subject areas

  • Medicine(all)
  • Internal Medicine


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