ABSTRACT
Poisonous snakes occur throughout most parts of the tropical and temperate zones of the world, though they are more numerous in tropical or semitropical areas. Usually limited to area of wound in puff adder and European viper bites. The pathologic findings in nervous tissue include changes in Nissl granules, fragmentation of the reticulum of the nerve cells, opacity of the nuclei, and fragmentation and swelling of the nucleoli. Acute granular degeneration may be seen in the cells of the anterior medulla. Swelling, edema, and local pain beginning within 10 min. Discoloration of skin and ecchymosis develop over several hours and progress to petechiae and hemorrhagic vesiculations. In 1991 there were five deaths from venomous reptile bites in the USA; each year several thousand patients receive antiserum. Worldwide, deaths have been estimated at 30 000—40 000. In crotalid envenomization with minimal systemic symptoms and signs, give 3–5 vials of andvenom.
