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The clinical course and treatment of black mamba (Dendroaspis polylepis) envenomations: a narrative review

Authors :
Nastya A. Kovalenko
Jashvin L. R. Oediet Doebe
Marcel A.G. van der Heyden
Max F. Troenokarso
Ubah Mahamuud
Maaike Wulfse
Leila Belbachir
Maurits F. van Binsbergen
Myrthe Meurs
Mark Aalten
Eran R. A. N. Arntz
Carsten F. J. Bakhuis
Ilias Asaggau
Source :
Clinical Toxicology. 59:860-868
Publication Year :
2021
Publisher :
Informa UK Limited, 2021.

Abstract

The black mamba (Dendroaspis polylepis) is, due to its extremely toxic venom, one of the most dangerous snake species in Sub-Saharan Africa. A D. polylepis bite is a medical emergency and requires adequate action to prevent severe complications. However, there are no comprehensive reviews available based on clinical cases, and no readily accessible guidelines for standardized treatment. Therefore, we aim to provide an overview regarding the currently available clinical literature on D. polylepis envenomations; in order to promote knowledge on symptomatology and treatment options. We searched for cases reporting humans bitten by D. polylepis in PubMed, Embase, Scopus, and Sabinet. We searched the reference lists of all eligible articles for additional articles. After quality assessment, 29 cases were included in this review. We used descriptive analysis to create an overview of the collected parameters. Among the included case reports and case series, D. polylepis envenomations most frequently resulted in decreased respiratory function, sweating and paralysis. The onset of symptoms usually occurred within 60 minutes. Neurological symptoms occurred more often than symptoms of autonomic dysfunction. In the reported cases most patients (26/29) received antivenom and most survived (25/29). We recommend the reporting of additional structured case reports to improve future analyses on the clinical course of envenomations, in order to improve public health response to D. polylepis envenomations.

Details

ISSN :
15569519 and 15563650
Volume :
59
Database :
OpenAIRE
Journal :
Clinical Toxicology
Accession number :
edsair.doi.dedup.....d100ec9622bc74f9e3b5e45f6aa83745
Full Text :
https://doi.org/10.1080/15563650.2021.1943427