PLoS Neglected Tropical Diseases (Jan 2023)

Frequency, clinical characteristics and outcomes of Tropidolaemus species bite envenomations in Malaysia.

  • Ahmad Khaldun Ismail,
  • Muhammad Nadzmi Hadi Abd Hamid,
  • Nur Alissa Ariff,
  • Vera Effa Rezar Frederic Ng,
  • Wan Chee Goh,
  • Nur Syafiqah Abdul Samat,
  • Annuar Muhammad Zuljamal Osman,
  • Ruth Sabrina Safferi,
  • Zainalabidin Mohamed Ismail

DOI
https://doi.org/10.1371/journal.pntd.0010983
Journal volume & issue
Vol. 17, no. 1
p. e0010983

Abstract

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Pit vipers from the genus Tropidolaemus are identified as one of the common causes of snake bite from venomous species in Malaysia. All Tropidolaemus species bite cases referred to the Remote Envenomation Consultation Services (RECS) between 2015-2021 were included. A total of 4,718 snake-related injuries cases consulted to RECS with 310 (6.6%) involved Tropidolaemus species; of these 190 (61.3%) were T. subannulatus and 120 (38.7%) T. wagleri. All the T. subannulatus cases occurred in Sabah and Sarawak while all cases of T. wagleri occurred in Peninsular Malaysia. The majority of patients were male (74.8%) and adults between 18-59 years old (61.2%). The upper limb (56.6%) was the most frequent anatomical region involved. Most cases were non-occupationally related (75.4%). Bites from both species caused local pain (77.1%) and swelling (27.2%). Most patients complained of mild pain (48.0%). Paracetamol (40.0%) was the most common analgesic prescribed. Antivenom was not indicated in all cases. Two patients were given antivenom inappropriately before RECS consultation. Most patients (54.7%) needed hospital observation for less than 24 hours. No deaths occurred in the group studied.