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Am. J. Trop. Med. Hyg., 73(3), 2005, pp. 583-585
Copyright © 2005 by The American Society of Tropical Medicine and Hygiene

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Right arrow Snake Bite

OCCIPITAL INFARCTION REVEALED BY QUADRANOPSIA FOLLOWING SNAKEBITE BY BOTHROPS LANCEOLATUS

HAROLD MERLE*, ANGÉLIQUE DONNIO, LUCAS AYEBOUA, YVES PLUMELLE, DIDIER SMADJA, AND LAURENT THOMAS
Department of Ophthalmology, Hematology Laboratory, Department of Neurology, and Emergency Department, University Hospital Center of Fort de France, Fort de France, Martinique

We report a case of snakebite in which envenomation was manifested through impairment of the visual field. The patient, a 46-year-old man, was bitten on the right thumb by Bothrops lanceolatus. Treatment with a specific equine antivenom (Bothrofav®) was administered one hour after the bite. With the exception of fang marks, the results of a clinical examination, particularly the neurologic component, were normal. The day after the bite, the patient developed an inferior left lateral homonymous quadranopsia with macular epargne. T2 magnetic resonance imaging showed a right occipital infarction. His condition improved clinically and biologically. This observation of snakebite is the first in which envenomation was accompanied exclusively by an impairment of the visual field. Envenomation by B. lanceolatus is distinct in its incidence of significant thrombotic complications at a distance from the site of the bite.

Received March 11, 2005. Accepted for publication April 14, 2005.

* Address correspondence to Harold Merle, Department of Ophthalmology, Pierre Zobda-Quitman Hospital, BP 632, 97261 Fort de France Cedex, Martinique. E-mail: harold.merle{at}chu-fortdefrance.fr

Authors’ addresses: Harold Merle, Angélique Donnio, and Lucas Ayeboua, Department of Ophthalmology, Pierre Zobda-Quitman Hospital, BP 632, 97261 Fort de France Cedex, Martinique, Telephone: 596-55-22-51, Fax: 596-75-84-47, E-mail: harold.merle{at}chu-fortdefrance.fr. Yves Plumelle, Hematology Laboratory, University Hospital Center of Fort de France, Fort de France, Martinique. Didier Smadja, Department of Neurology, University Hospital Center of Fort de France, Fort de France, Martinique. Laurent Thomas, Emergency Department, University Hospital Center of Fort de France, Fort de France, Martinique.

Reprint requests: Harold Merle, Department of Ophthalmology, Pierre Zobda-Quitman Hospital BP 632, 97261 Fort de France Cedex, Martinique.




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Macular Infarction Following Viperine Snake Bite
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