Challenges of a West African green mamba (Dendroaspis viridis) envenomation in a European urban setting: A case report with quantitative monitoring of neuromuscular transmission - Eidenbenz, D.; Scotti, C.; Larréché, S.; Pagani, J. L.; Carron, P. N. (Toxicon, 2025)
Although rare, exotic snakebites are a growing medical concern worldwide, partly due to the rising popularity of exotic pet ownership in high-income countries. Envenomation from family Elapidae snakes may cause severe neurological and local symptoms. Timely antivenom administration is crucial, but often complicated by logistical challenges. We report a case of a West African green mamba (Dendroaspis viridis) envenomation in a 59-year-old male in Switzerland who developed progressive weakness and respiratory failure, associated with swelling of a limb. Quantitative neuromuscular stimulation, also known as a train-of-four monitor, was used to assess neuromuscular transmission after antivenom administration. This case highlights the clinical and organizational challenges following an exotic snakebite. © 2025 The Authors
Keywords: journalArticle; Animals; Antivenins; Article; Dendroaspis; Dendroaspis viridis; Elapid Venoms; Elapid venom; Elapidae; Glasgow coma scale; Humans; Snake Bites; Snake envenomation; Snakebite; Switzerland; Trimeresurus sumatranus; adult; allodynia; animal; artificial ventilation; blood gas; breathing rate; case report; clinical article; drug therapy; emergency physician; emergency ward; endotracheal intubation; envenomation; fentanyl; high income country; human; male; metabolic acidosis; metabolic stress; middle aged; neurologic examination; neuromuscular blocking; neuromuscular transmission; oxygen saturation; paresthesia; pathophysiology; peak expiratory flow; propofol; quantitative analysis; respiratory alkalosis; respiratory failure; rhabdomyolysis; rocuronium; snake; snake venom; swelling; therapy; venom antiserum; weakness; wound care