Biology Reference
In-Depth Information
and extensive superficial ecchymoses as well as hematomas (
Plate 4.20J-L
). In fatal
cases, widespread petechial hemorrhages are seen at autopsy in serosal cavities,
heart, walls of the great vessels, and elsewhere with obvious sites of severe bleed-
ing in the stomach and bladder (Spies et al., 1962). Histopathological appearances
included diffuse fibrin microthrombi in brain, liver, and lungs, and hemoglobin casts
in the renal tubules (Lakier and Fritz, 1969; Spies et al., 1962). Both intravascular
and microangiopathic hemolysis leading to hyperbilirubinemia and hemoglobinuria
have been described (Lakier and Fritz, 1969; see Section 4.6). The misleading term
“hemolytic uremic syndrome” is sometimes applied (Du Toit, 1980). Most fatali-
ties occurred within a few days of the bite but some, attributable to acute tubular
necrosis, were delayed for many days. Local envenomation is usually trivial apart
from some pain, but several patients developed local swelling; one had swelling
of the entire bitten arm, with sloughing of necrotic skin at the bite site on his hand
(E)
(F)
(G)
Plate 4.20
(E)
Dispholidus typus
, view of the enlarged posterior maxillary teeth.
(F and G) Additional views of the enlarged posterior maxillary teeth of
Dispholidus
typus
.
Plate 4.20F
Male, Ghana;
Plate 4.20G
Kenya
(see also Plate 2.13).
