IntroductionMost cases of red‐bellied black snake (RBBS) envenomation in dogs respond favourably to treatment comprising of tiger‐brown snake antivenom (TBAV), intravenous fluid therapy, analgesia and, if indicated, mechanical ventilation and/or blood transfusion. However, there remains a subset of patients who develop fatal complications despite intensive treatment and risk factors for these occurring remain unknown. Here we present a retrospective cross‐sectional survey of 91 canine and feline RBBS envenomation cases.MethodsCases seen between June 2010 and June 2020 were retrieved from the databases of seven practices in South East and coastal Queensland. From the canine case population, logistic regression analysis was performed to assess the impact of potential risk factors at presentation on the likelihood of death. A final multivariable model was developed using a manual backwards elimination approach based on overall likelihood ratio tests and Wald chi‐square P‐values for each variable. Where model convergence failed due to quasi‐complete separation, Firth's penalised maximum likelihood method was implemented. Such separation may occur when an outcome is completely predicted by an explanatory variable in one group.ResultsOf the 88 canine cases, 7 died (8.0%), all after prognosis‐based euthanasia. Of the three feline cases, one died after unsuccessful resuscitation following cardiopulmonary arrest. Compared to survivors, dogs that died were older, exhibited pigmenturia, received antivenom later and had a higher total plasma protein (TPP), activated clotting time (ACT) and lower packed cell volume (PCV) at presentation.

2015-12-01·Toxicon3区 · 医学

Clinical features of serum sickness after Australian snake antivenom

3区 · 医学

Article

作者: Downes, Michael A ; Ryan, Nicole M ; Isbister, Geoffrey K

Serum sickness is a delayed immune reaction in which the immune system responds to a protein in antiserum as a potentially harmful substance and mounts an IgG-mediated antibody response. A 32 year-old female patient had systemic envenoming following a bite by a red-bellied black snake (Pseudechis porphyriacus). She was treated with Tiger snake antivenom and recovered over 24 h and did not develop myotoxicity. She then presented with local pain, itching and swelling, which was partially treated with antihistamines. Eleven days after the bite she presented again with symptoms of worsening serum sickness including rash on the upper legs, joint and muscle pain in arms, ankles and knees, and nausea. The patient was prescribed five days of prednisone 50 mg/day, antihistamine 10 mg/day and analgesia 1000 mg/day and improved over 2 days. She had no further problems on follow up at 4 months. This case highlights that serum sickness can cause significant effects after the treatment of snake envenoming. It develops 5-14 days after antivenom administration and has characteristic clinical and laboratory features. Severe cases of serum sickness can result in morbidity but it appears to respond well to corticosteroid treatment.

2012-08-01·Medical Journal of Australia2区 · 医学

Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP‐13)

2区 · 医学

Article

作者: Geoffrey K Isbister ; Margaret A O'Leary ; Matthew Elliott ; Simon G A Brown

OBJECTIVESTo describe the clinical syndrome associated with definite tiger snake (Notechis spp) envenoming and to examine the ability of tiger snake antivenom (TSAV) to bind free venom in vivo.DESIGN, SETTING AND PARTICIPANTSWe conducted a prospective cohort study within the Australian Snakebite Project, reviewing all definite tiger snake envenoming cases between October 2004 and June 2011. Definite cases were identified by venom-specific enzyme immunoassay or expert snake identification.MAIN OUTCOME MEASURESClinical effects of tiger snake envenoming; peak venom concentrations; number of vials of antivenom administered.RESULTSFifty-six definite tiger snake envenomings were identified. Clinical effects included venom-induced consumption coagulopathy (VICC) (n = 53), systemic symptoms (n = 45), myotoxicity (n = 11) and neurotoxicity (n = 17). Thrombotic microangiopathy occurred in three patients, all of whom developed acute renal failure. There were no deaths. A bite-site snake venom detection kit test was done in 44 patients, but was positive for tiger snake in only 33 cases. Fifty-three patients received TSAV and eight of these patients had immediate hypersensitivity reactions, severe enough in one case to satisfy diagnostic criteria for severe anaphylaxis. The median peak venom concentration in 50 patients with pretreatment blood samples available was 3.2 ng/mL (interquartile range [IQR], 1-12 ng/mL; range 0.17-152 ng/mL). In 49 patients with post-treatment blood samples available, no venom was detected in serum after the first antivenom dose. Ten patients were given 1 vial of TSAV; the median dose was 2 vials (range, 1-4 vials). Pretreatment serum venom concentrations did not vary significantly between patients given 1 vial of TSAV and those given 2 or more vials.CONCLUSIONTiger snake envenoming causes VICC, systemic symptoms, neurotoxicity and myotoxicity. One vial of TSAV, the dose originally recommended when the antivenom was first made available, appears to be sufficient to bind all circulating venom.

100 项与 Tiger Snake Antivenom(CSL Ltd.) 相关的药物交易

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