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Q J Med 2001; 94: 551-559
© 2001 Association of Physicians

Coagulopathy following lethal and non-lethal envenoming of humans by the South American rattlesnake (Crotalus durissus) in Brazil

I.S. Sano-Martins, S.C. Tomy, D. Campolina1, M.B. Dias1, S.C.B. de Castro, M.C.C. de Sousa-e-Silva, C.F.S. Amaral2, N.A. Rezende2, A.S. Kamiguti3, D.A. Warrell4 and R.D.G. Theakston5

From the Laboratório de Fisiopatologia, Instituto Butantan, São Paulo, Brazil, 1 Hospital João XXIII, Minas Gerais, Belo Horizonte, Brazil, 2 Departamento de Medicina Interna, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, 3 University Department of Haematology, Royal Liverpool Hospital, Liverpool, UK, 4 Centre for Tropical Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK and 5 Liverpool School of Tropical Medicine, Liverpool, UK

Received 16 May 2001 and in revised form 3 August 2001

The South American tropical rattlesnake (Crotalus durissus subspp) is responsible for ~10% of bites from venomous snakes in Brazil. We studied 24 victims of bites by this species over 3 years, in south-eastern Brazil, particularly investigating haemostatic alterations. Thirteen patients were defined as moderately envenomed and 11 as severe. There were two deaths, which were not attributed to venom-induced haemostatic disturbances. However, envenoming by C. durissus is frequently associated with haemostatic disorders, which are probably attributable mainly to the action of the thrombin-like enzyme, with possible additional effects secondary to the powerful myotoxic activity of the venom.

Address correspondence to Dr Ida S. Sano-Martins, Instituto Butantan, Laboratório de Fisiopatologia, Av. Vital Brazil, 1500, 05503 900, São Paulo (SP), Brazil. e-mail: lusiada{at}uol.com.br


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