Case Report: Recent Case Reports of Levant Blunt-Nosed Viper Macrovipera lebetina obtusa Snakebites in Iran
Envenomation and death resulting from snakebites represent a significant public health problem worldwide, particularly in tropical and subtropical regions. The WHO has defined snakebite as a neglected tropical health concern. Bites from Macrovipera lebetina obtusa usually cause life-threatening systemic hemodynamic disturbances, reduced functionality of the kidneys, and other serious symptoms, including hypotension shock, edema, and tissue necrosis, at the bite site. Herein, we highlight five cases of M. l. obtusa envenomation that presented with wide-ranging manifestations. Many recovered cases were left with long-term musculoskeletal disabilities. In a particular case, a 15-year-old male patient was envenomed in his palm by an 80-cm M. l. obtusa. Within 12 hours, swelling extended to near the shoulder. Fasciotomy was performed on the forearm and part of the upper arm of this patient. Symptoms of severe localized pain and swelling, dizziness, weakness, low blood pressure, and itching around the bite area were documented. The patient remained in the hospital for 13 days.
Author Notes
Disclosure: The present descriptive studies based on medical records of Valie Asr (Qazvin Province), Loghman Hakim (Tehran), Imam Khomeini (Kermanshah Province), Taleqani (Kermanshah Province), and Shahid Gholi Pur (West Azerbaijan) hospitals. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the National Committee for Ethics in Biomedical Research under protocol numbers IREC-9540005214 and IREC-85700003541. Written informed consent was obtained from the patients for their anonymized information to be published in this article.
Authors’ addresses: Seyed Mahdi Kazemi, Zagros Herpetological Institute, Qom, Iran, E-mail: kazemi_m1979@yahoo.com. Ahmed Al-Sabi, College of Engineering and Technology, American University of the Middle East, Egaila, Kuwait, E-mail: ahmed.al-sabi@aum.edu.kw. Chengbo Long, Key Laboratory of bioactive peptides of Yunnan Province/Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China, E-mail: longchengbo@mail.kiz.ac.cn. Mahmoud I. Shoulkamy, Guangdong Key Laboratory of Genome Stability and Disease Prevention, Shenzhen University School of Medicine, Shenzhen, Guangdong, China, and Zoology Department, Faculty of Science, Minia University, Egypt, E-mail: mahmoud.ibrahim1@mu.edu.eg. Tarek Mohamed Abd El-Aziz, Zoology Department, Faculty of Science, Minia University, Egypt, and Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, E-mail: mohamedt1@uthscsa.edu.