Clinical Aspects of Green Pit Viper Bites in Bangladesh: A Study on 40 Patients

Background: Green pit viper bite is an important cause of morbidity in Bangladesh. The objective of this study was to investigate the characteristics and clinical presentations of green pit viper bite in Bangladesh. Methods: This prospective observational study was done in the department of Medicine in Chittagong Medical College Hospital, Bangladesh. A total of 40 patients with history of green pit viper bite presented with local swelling and hematological abnormality were enrolled. Clinical and demographic features of patients were entered into a checklist. A careful assessment of grading of swelling and a 20 minute whole blood clotting test was done for every patient. Results: Patients’ age ranged from 10 to 65 years with majority in 11 to 40 years group. Most bites occurred during daytime while the patients were busy in plantation, gardening and cultivation. Most of the patients received one or more harmful traditional treatments such as multiple tight ligatures (90%). The most common clinical manifestation was local swelling found in 100% of patients followed by incoagulable blood (65%), lymphadenitis (62.5%) and fang marks (60%). All patients received supportive treatments and were rehabilitated. Conclusion: Widely practiced traditional treatments must be discouraged and community education for the people should be arranged for first aid treatments and quick transfer to the nearest hospital. Young and working people should take precautions during agricultural activities. The national guideline for management of snakebite should be encouraged to practice everywhere in Bangladesh.