Clinical study of 81 cases of"Mamushi"viper bite during the past 11 years

We reviewed a total of 81 Mamushi viper (Gloydius blomhoffii) bite patients (51 males and 30 females) who required hospitalization from 2004 to 2014. Their average age was 57.3 years and 21 patients were in their sixties, which was the largest age group by decade. The most prevalent season for bites was between July and October. The onset time showed twin peaks, 46 cases were bitten between 4 p.m. to 12 a.m. hours and 16 cases were bitten between 8 a.m. to 12 p.m. hours. Mamushi bites occurred most frequently at farms (21 cases), followed by urban neighborhoods (14 cases). The main site of injury was the fingers (43 cases), followed by the foot or heel (16 cases). As many as 74 cases arrived at the hospital within 6 hours after onset. On their first visit, the severity tended to be mild (GradeI; 19 cases, Grade II; 38 cases). However, the peak severity became gradually higher (Grade III ; 27 cases, Grade IV; 25 cases). Patients with the more severe grades of injury tended to manifest higher serum levels of creatine kinase and longer hospitalization periods. None of the cases resulted in death or disseminated intravascular coagulation, however, 1 case developed renal failure and 6 cases developed diplopia. Seventy of the 81 cases were treated with Cepharanthine® and 45 with systemic corticosteroid. Antivenom was injected in 52 cases by intravenous administration. In addition, 78 cases were treated with antibiotics to prevent secondary infection. Prevention therapy for tetanus was carried out in 56 cases.