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Rhabdophis subminiatus (Plate
4.45A-C) Red-necked keel-back; ular
pitjung; ular lempeh
9 (10)
AEM, An, BL, CCo (DIC), E, Ecc, Ep, H, HA,
He, Hep, HM, HT, F, L, Mel, N, PA, Thp, V
{In case reported by Mather et al. (1978), slight
jaundice was noted and several concerning
symptoms occurred between 48 and 72 h postbite.
Hoffmann et al. (1992) noted a lack of ARF
or Thp in their patient despite a severe DIC.
Their patient also exhibited depleted Protein C.
Similarly, Li et al. (2001) noted a lack of serious
multiple organ damage despite DIC with “severe”
hemorrhage. Smeets et al. (1991) reported
myoglobinuria with a normal CK, and a transient
rise in creatinine. Most cases involved treatment
with multiple units of FFP, PRBC, and platelets.
Aside from supporting a steady hematocrit, these
infusions were ineffective. The cases reported
by Mather et al. (1978), Cable et al. (1984), and
Seow et al. (2000) featured protracted bites. The
case histories reported by Viravan et al. (1992)
support the role of protracted bites influencing
the severity of bites from this species. These
authors described five insignificant bites from R.
subminiatus . None of these involved intentional
handling of the culprit snake (all were accidental,
i.e., victim stepped on snake). These cases are
not included in the tally here. See Section 4.3 for
further discussion, and description of a recent
additional case is included in Section 4.6}
Mather et al. (1978); Cable
et al. (1984); Smeets et al.
(1991); Zotz et al. (1991);
Hoffmann et al. (1992);
Kijjirah et al. (1998);
Seow et al. (2000); Li et al.
(2001); this study
A
( Continued )
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