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Table 1 Patient Characteristics

From: RETRACTED ARTICLE: Severe Viperidae envenomation complicated by a state of shock, acute kidney injury, and gangrene presenting late at the emergency department: a case report

First author, year of publication, study designPatient number, age, gender,professionRegion of Cameroon and site of the incidentSite of snake bite on the bodySnake speciesDelay before hospital presentationSigns of envenomationManagementOutcome
Nkwescheu [10], 2016, case reportPatient 1;
28 year, male, physician
Northern Cameroon, in bedroomRight handNaja melanoleucaWithin an hourSwollen hand, rigors, foaming at the mouth, loss of speech and severe respiratory distress.One vial AVS, Fluid resucitation, Atropine 1 mg IV, Ranitidine 50 mg IV, Paracetamol 500 mg IV.fatal
Tianyi, 2017 [11], case reportPatient 2:
10 years, female, occupation not precised
Adamawa region, in the farmRight templeUnidentified snake species12 hMarked facial swelling, haematuria, pain, bleeding from the wound and mouth, mild respiratory distress.Topical application and oral ingestion of herbal concoctions, 1 vial of AVS, 1500 IU anti-tetanus serum SC, dexamethasone 4 mg IV every 8 h, ceftriaxone 450 mg every 12 h, wound dressing, Normal saline 100 ml/h.Complete recovery
Tianyi, 2018[12], case series of two patientsPatient 3: 80 years, male, traditional healerAdamawa region, in the bushLeft legNaja melanoleucaDied on the way to the hospitalInability to stand, and difficulties in speaking, loss of consciousness.Application of traditional topical ointments on the wounds, ingestion of herbal concoctions, no AVS administered.fatal
 Patient 4:
3 years, female
Adamawa region, in the bushLeft legUnidentified snake speciesFour hoursInability to stand, talk and open her eyes, breathing difficulties, convulsion, a state of shock.Tourniquet applied on left thigh, fluid resuscitation, 750 IU anti-tetanus serum SC, dexamethazone 4 mg IM, AVS not available.fatal
The present case reportPatient 5:
47 years old female farmer
Centre region, in the farmRight thumbEchis occellatus20 ha state of shock, acute kidney injury, coagulopathy and gangrene.Topical application and oral ingestion of herbal, concoctions, fluid resuscitation, anti-tetanus serum 1500 IU SV, ceftriaxone 2 g/24 h IV, metronidazole 500 mg/8 h IV, adrenaline 1:1000 dilution at 0.2 mg every 5 min IV, promethazine 25 mg/8 h IV, Paracetamol 1 g/06 h IV, tramadol 100 mg/8 h IV, methylprednisolone 80 mg/kg IV, three vials of polyvalent anti-venom sera IV, Noradrenaline 0.3/kg/min using EPS, and transfusion of three units of fresh frozen plasma.fatal
  1. AVS: anti-venom serum; SC: subcutaneous; IV: intravenous; IM: intramuscular; EPS: Electric pump syringe
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