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QJM Advance Access originally published online on July 22, 2008
QJM 2008 101(10):801-806; doi:10.1093/qjmed/hcn079
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Neurotoxicity and hypertension following European adder (Vipera berus berus) bites in Hungary: case report and review

T. Malina1, L. Krecsak2 and D.A. Warrell3

From the 1Department of Systematic Zoology and Ecology, University of Szeged, Dugonics tér 13, H-6722 Szeged, 2Department of Systematic Zoology and Ecology, Eötvös Loránd University, Pázmány Péter s. 1/C, H-1117 Budapest, Hungary and 3Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK

Address correspondence to T. Malina, Department of Systematic Zoology and Ecology, University of Szeged, Dugonics tér 13, H-6722 Szeged, Hungary. email: dyspholidus@gmail.com

The first 150 words of the full text of this article appear below.


   Introduction
 
In Europe, the common adder (Vipera berus) is extensively distributed and causes more bites than any other species in the genus Vipera.1 In Hungary, there are two subspecies; the nominate form (V. b. berus) in the East and Northeast and the Bosnian adder (V. b. bosniensis) in the Southwest (Figures 1 and 2).2


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  		Figure 1. Common adders (Vipera berus) from Hungary: (a and b) V. b. berus, female specimens from the population where our patient was bitten (Vámosatya, Szabolcs–Szatmár–Bereg County, E Hungary) (Photographs Tamás Malina). (c) V. b. bosniensis female from Darvaspuszta, Somogy County, SW Hungary (Photographs Zoltán Korsós).

 

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  		Figure 2. Distribution of Vipera berus populations are shown by grey shaded areas in eastern Hungary. The black square is the location of the present case described. Legend: Vipera berus berus populations are marked by grey shading, V. b. bosniensis . . . [Full Text of this Article]

 
Case report

   Discussion
 

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