Envenomization by bothrops lanceolatus

Envenomization by Bothrops lanceolatus

Envenomization by *Bothrops lanceolatus*, commonly known as the Martinique lancehead or fer-de-lance, is a medical condition resulting from the bite of this venomous pit viper species. This snake is endemic to the island of Martinique in the Caribbean. The envenomation can lead to significant morbidity and, in rare cases, mortality if not treated promptly and appropriately.

Clinical Presentation

The clinical presentation of envenomization by *Bothrops lanceolatus* can vary depending on the amount of venom injected, the location of the bite, and the time elapsed before treatment. Common symptoms include:

• Local Effects: Immediate pain, swelling, and bruising at the site of the bite. The swelling can progress rapidly and may involve the entire limb.
• Systemic Effects: Nausea, vomiting, dizziness, and hypotension. Severe cases may lead to coagulopathy, characterized by bleeding and clotting disorders.
• Complications: In some cases, envenomation can lead to compartment syndrome, renal failure, or necrosis of the affected tissue.

Pathophysiology

The venom of *Bothrops lanceolatus* contains a complex mixture of enzymes, peptides, and proteins that contribute to its toxic effects. Key components include:

• Metalloproteinases: These enzymes degrade extracellular matrix proteins, leading to tissue damage and hemorrhage.
• Phospholipases A2: These enzymes disrupt cell membranes, causing cell lysis and inflammation.
• Serine Proteases: These enzymes interfere with the coagulation cascade, leading to coagulopathy.

Diagnosis

Diagnosis of envenomization by *Bothrops lanceolatus* is primarily clinical, based on the history of snakebite and the characteristic symptoms. Laboratory tests may show:

• Coagulation Profile: Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT).
• Complete Blood Count (CBC): Thrombocytopenia may be present.
• Renal Function Tests: Elevated creatinine levels in cases of renal involvement.

Treatment

The management of envenomization by *Bothrops lanceolatus* involves both supportive care and specific interventions:

• First Aid: Immobilization of the affected limb and rapid transport to a medical facility.
• Antivenom: Administration of specific antivenom is the mainstay of treatment and should be given as soon as possible.
• Supportive Care: Includes pain management, fluid resuscitation, and monitoring for complications such as compartment syndrome.
• Surgical Intervention: May be necessary in cases of severe tissue necrosis or compartment syndrome.

Prevention

Preventive measures include:

• Public Education: Raising awareness about the presence of *Bothrops lanceolatus* and the importance of avoiding snake habitats.
• Protective Clothing: Wearing boots and long pants when walking in areas where the snake is known to inhabit.

Prognosis

With prompt and appropriate treatment, the prognosis for individuals bitten by *Bothrops lanceolatus* is generally good. However, delays in treatment can lead to significant complications and increased risk of mortality.

Also see

• Snakebite
• Antivenom
• Coagulopathy
• Compartment syndrome