Proatheris superciliaris, the lowland swamp viper, has a limited distribution along lakeshores and rivers in Malawi, Southern Tanzania, and central Mozambique. Its venom is known to be procoagulant. Only five P. superciliaris bites have been reported, all inflicted by captive snakes, and none was fatal. Here we present a case of sudden death following a bite by Proatheris superciliaris in rural Malawi that cannot be attributed to envenoming. A healthy 32-year-old woman was planting rice in a flooded rice paddy field when she suddenly told her sister in a quiet voice that she had been bitten by a snake. She then collapsed face-upwards into the ankle-deep water. She remained motionless while her sister and uncle carried her out of the rice paddy onto dry land a few meters away. The victim did not regain consciousness. Her uncle heard one exhalation but no further breathing. The snake responsible was killed by a friend. Although the venom of this species can cause life-threatening coagulopathy, this woman's death occurred too rapidly to be attributable to envenoming. Only two explanations seem plausible: anaphylaxis, or vasovagal shock triggered by fear. In the present case, the victim died within minutes of the bite, closely observed by her anxious relatives, but showed no features of anaphylaxis. In Malawi, as in much of sub-Saharan Africa, many people are reportedly terrified of snakes, believing that bites by almost any species can cause rapid death. In this case, death occurred less than 2 min after a bite from Proatheris superciliaris. We believe that the cause of death was most likely a severe vasovagal attack, in response to the fear and pain of the snakebite that triggered vasodilatation, bradycardia, and hypotension leading to cardiac arrest.
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http://dx.doi.org/10.1016/j.toxicon.2023.107324 | DOI Listing |
Toxicon
November 2023
Nuffield Department of Clinical Medicine, University of Oxford, UK.
Proatheris superciliaris, the lowland swamp viper, has a limited distribution along lakeshores and rivers in Malawi, Southern Tanzania, and central Mozambique. Its venom is known to be procoagulant. Only five P.
View Article and Find Full Text PDFToxins (Basel)
December 2022
Venom Evolution Lab, School of Biological Science, University of Queensland, St. Lucia, QLD 4072, Australia.
Comp Biochem Physiol C Toxicol Pharmacol
February 2021
Toxin Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072, Australia. Electronic address:
Bitis are well known for being some of the most commonly encountered and medically important snake species in all of Africa. While the majority of species possess potently anticoagulant venom, only B. worthingtoni is known to possess procoagulant venom.
View Article and Find Full Text PDFToxicon
June 2014
Department of Nephrology and Renal Transplantation, University Hospital and University of Poitiers, France. Electronic address:
Acute bilateral renal cortical necrosis (BRCN) has been reported following envenoming by exotic venomous snakes. Proatheris superciliaris is a rare viper with restricted distribution in east Africa. Very little information is available on envenoming by this species.
View Article and Find Full Text PDFClin Toxicol (Phila)
April 2014
Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital, Prague , Czech Republic.
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