TY  - JOUR
TT  - The Compartment Syndrome Associated with Deep Vein Thrombosis due to Rattlesnake Bite: A Case Report
AU  - Tincu, Radu Ciprian
AU  - Ghiorghiu, Zoie
AU  - Tomescu, Dana
AU  - Macovei, Radu Alexandru
PY  - 2017
DA  - July
JF  - Balkan Medical Journal
PB  - Trakya University
WT  - DergiPark
SN  - 2146-3123
SP  - 367
EP  - 370
VL  - 34
IS  - 4
KW  - Snakebite
KW  - developed deep vein thrombosis
KW  - compartment syndrome
N2  - Background: Snakebite is a health issue specific to some parts of the world, especially in the tropical area, where it produces many victims. The main clinical damage caused by snake bite involves hemotoxic, neurotoxic and myotoxic reactions. It is also established that the importance of systemic impairment varies according to individual factors and are related to organ dysfunction, shock or hypotension. We report the case of a young woman suffering from snakebite who developed deep vein thrombosis and compartment syndrome.     Case Report: We present the case of a 32-year-old Romanian woman who was injured by her own Crotalinae snake (also known as pit viper or rattlesnake) on her left forearm. When admitted to our Emergency Department, she was conscious with a Glasgow coma scale of 12/15, somnolent, febrile, suffering of headache, tachypnea; the marks of the snakebite were located in the distal part of the anterior left forearm; she had pain and bleeding at the bite site and swelling of the left upper limb with lymphangitis up to the axilla. She experienced fasciotomy-requiring compartment syndrome of the upper limb and required unfractionated heparin and closed monitored using activated partial thromboplastin time evolution due micro-thrombosis in the brachial vein. Local improvement was achieved in the next 4 days with progressive diminish of local tenderness and swelling.   Conclusion: Limb deep vein thrombosis might be induced by snakebite, despite pro-hemorrhagic general condition induced by the envenomation. High index of clinical suspicion is needed for early diagnosis and timely management which can improve survival of these patients.     Keywords: Snakebite, developed deep vein thrombosis, compartment syndrome
CR  - 1. Mohapatra B, Warrell DA, Suraweera W, Bhatia P, Dhingra N, Jotkar RM,
et al. Snakebite mortality in India: a Nationally representative mortality
survey. Plos Negl Trop Dis 2011;5:e1018.
CR  - 2. Spiller HA, Bosse GM. Prospective study of morbidity associated with
snakebite envenomation. J Toxicol Clin Toxicol 2003;41:125-30.
CR  - 3. Tucker SC, Josty I. Compartment syndrome in the hand following an adder
bite. J Hand Surg Br 2005;30:434-5.
CR  - 4. Downey DJ, Omer GE, Moneim MS. New Mexico rattlesnake bites:
demographic review and guidelines for treatment. J Trauma 1991;31:1380-
6.
CR  - 5. Cortelazzo A, Guerranti R, Bini L, Hope-Onyekwere N, Muzzi C, Leoncini
R, et al. Effects of snake venom proteases on human fibrinogen chains.
Blood Transfus 2010;8:120-5.
CR  - 6. Thomas L, Tyburn B, Bucher B, Pecout F, Ketterle J, Rieux D, et al.
Prevention of thromboses in human patients with Bothrops lanceolatus
envenoming in Martinique: failure of anticoagulants and efficacy of a
monospecific antivenom. Research Group on Snake Bites in Martinique.
Am J Trop Med Hyg 1995;52:419-26.
CR  - 7. Dagda RK, Gasanov S, De La Oiii Y, Rael ED, Lieb C. Genetic basis
for variation of metalloproteinase-associated biochemical activity in
venom of the Mojave rattlesnake (Crotalus scutulatus). Biochem Rest Int
2013;2013:251474.
CR  - 8. Massey DJ, Calvete JJ, Sanchez EE, Sanz L, Richards K, Curtis R et al.
Venom variability and envenoming severity outcomes of the Crotalus
scutulatus (Mojave rattlesnake) from southern Arizona. J Proteomics
2012;75:2576-87.
CR  - 9. Dagda RK, Gasanov SE, Zhang B, Welch W, Rael ED. Molecular
models of the Mojave rattlesnake (Crotalus scutulatus scutulatus) venom
metalloproteinases reveal a structural basis for differences in hemorrhagic
activities. J Biol Phys 2014;40:193-216.
CR  - 10. Natarajan N, Basheer A, Mookkappan S, Periyasamy S. Reversible lower
limb deep vein thrombosis following haemotoxic snakebite-a case report.
AMJ 2014;7:232-5.
UR  - https://dergipark.org.tr/en/pub/bmj/issue//502402
L1  - https://dergipark.org.tr/en/download/article-file/606605
ER  -