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Table 1..

Characteristic of puff adder patients in Kenyan clinical case series.

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Fig 1.

Biting snake and local effects of bite.

A*. Picture of biting snake taken by snakebite victim and used for snake identification. B*. Picture of biting snake brought to the health facility for snake identification. C. Puff adder bite to the right small toe, and black stone applied as an early intervention (Patient bitten by snake in Fig 1B above). D. Progressive swelling of entire right leg after a puff adder bite to the right small toe (Patient bitten by snake in Fig 1B above). *Both snakes identified as Bitis arietans by LSTM herpetologist Edouard Crittenden and KSRIC herpetologist Geoffrey Kephah.

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Fig 2.

PRISMA flow chart of studies assessed for this review.

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Table 2.

Summary of sociodemographic and clinical features of published cases of puff adder envenoming.

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Fig 3.

Clinical features and complications of puff adder bites in patients with wild and captive bites.

*Some patients had more than one feature or complication. The origin of the snake was not reported in three cases.

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Table 3.

Serial laboratory assays of published cases of puff adder envenoming.

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