Fig 1.
Live hump-nosed pit vipers brought by the patients.
(a), (b) Hypnale zara (thick black arrow indicates the prominent hump and thin black arrow indicates the characteristic nuchal colour band (c), (d), (e), (f) Hypnale hypnale (hump is not prominent).
Table 1.
Demographic and epidemiological features of hump-nosed pit viper (H. Hypnale and H. zara) bites in children.
Fig 2.
Multiple sites of bite in S.No.21 patient.
(a) 2 fang punctures on face (circled) on day 1 (b) full recovery on day 4 (c) fang puncture (circled) just above right knee joint (d) 2 punctures (circled) on right hand (e) 2 fang punctures (circled) over right 3rd finger (f) offending live hump-nosed pit viper: Hypnale zara from Kuruvita, Sri Lanka (06°77’N, 80°37’elevation 37m/ 121ft).
Fig 3.
Monthly distribution of hump-nosed pit viper bites in children.
Fig 4.
Local envenoming manifestations of hump-nosed pit viper bites in children.
(a) severe local swelling of left lower limb on day 2 (b) moderate local swelling of right lower limb on day 2 (c) haemorrhagic blister on right 2nd finger on day 3 (d) heamorrhagic blister on left big toe on day 2 (e) necrosis of right thumb (circled) on day 2 (f) bite marks on left 2nd finger on day 2.
Table 2.
Clinical features of hump-nosed pit viper (Genus: Hypnale) bites in children.
Table 3.
Laboratory findings of hump-nosed pit viper envenoming in children.
Table 4.
Descriptive statistics of laboratory findings in hump-nosed pit viper envenoming in children.
Fig 5.
Species of snake responsible for bite in case 1 patient-H. hypnale.
(a) dorsal aspect (b) ventral aspect (c) severe swelling of right lower limb (d) 3 fang punctures (circled) of the medial side of right foot.
Table 5.
Laboratory findings of patients who underwent fasciotomy.
Fig 6.
Carpel tunnel decompression and forearm fasciotomy of right hand in case 3 patient (a), (b) Note that the necrosis of the site of bite in middle finger and secondary suturing.