Trimeresurus Stejnegeri Scientific Classification and Study

Trimeresurus stejnegeri is a species of venomous snake found in Southeast Asia.

Its scientific classification is as follows: Kingdom: Animalia, Phylum: Chordata, Class: Reptilia, Order: Squamata, Family: Viperidae, Genus: Trimeresurus, and Species: T. stejnegeri.

Trimeresurus stejnegeri is a relatively small species of snake, with a typical length of about 60-70 cm.

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Trimeresurus stejnegeri grows to a maximum total length of 75 centimeters, including a tail length of 14.5 centimeters.

The species has a distinctive color pattern, with bright to dark green scales on top, pale green to whitish scales on the bottom, and a bright bicolored orange or brown and white ventrolateral stripe.

The dorsal scales are arranged in 21 longitudinal rows at midbody, and the ventrals number 150-174.

Males have hemipenes that are short and spinose beyond the bifurcation, while females have a bicolored or white ventrolateral stripe.

The species is carnivorous, feeding on small rodents, birds, frogs, and lizards.

Trimeresurus stejnegeri is also known by many common names, including bamboo viper, Chinese tree viper, and Stejneger's pit viper.

The species has a characteristic triangular-shaped head with red eyes containing vertical pupils in both males and females.

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Trimeresurus stejnegeri, also known as the Korean pit viper, is a species of venomous snake.

It belongs to the family Viperidae, specifically the subfamily Crotalinae.

The genus Trimeresurus is a group of pit vipers that are found in Southeast Asia and the Indian subcontinent.

Trimeresurus stejnegeri is a relatively small species of snake, typically growing to a length of about 60-70 cm.

It has a distinctive pattern of dark brown or black markings on a lighter brown or yellowish background.

The Korean pit viper is found in a variety of habitats, including forests, grasslands, and rocky areas.

The venom of the Trimeresurus stejnegeri, also known as the Stejnegeri's Viper, is a serious concern. It contains procoagulants, haemorrhagins, and can cause serious envenomation, potentially leading to death.

The venom can cause a range of local effects, including local pain, swelling, bruising, blistering, and minimal local necrosis. These symptoms can be severe and potentially life-threatening.

Treatment for a bite from the Stejnegeri's Viper is straightforward: antivenom is the recommended course of action. However, it's essential to seek medical attention immediately if you're bitten.

Here are the general effects of the venom:

The composition of venom can vary, but in the case of the venom we're reviewing, it contains procoagulants, which are substances that promote blood clotting. This can lead to serious envenomation, potentially making it lethal.

Local effects of the venom can be severe, including local pain, swelling, bruising, blistering, and minimal local necrosis. I've heard of cases where the pain has been so intense that it's hard to bear.

General effects of the venom can be just as concerning, with symptoms including nausea, headache, vomiting, general pain, dizziness, diarrhea, collapse, convulsions, moderate to severe coagulopathy, and hemorrhagic effects. In some cases, renal damage and shock are possible.

The treatment for this venom is straightforward: antivenom.

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The Stejnegeri's Viper is an ambush predator that waits in a single position ready to strike.

They are active at night, but sometimes roost in bushes during the day.

These vipers have relatively long retractable fangs and will bite readily at anything that comes within range.

Not prone to giving chase, they'll hold their ground if they feel cornered.

A bite from a Stejnegeri's Viper is considered very serious and medical attention should be sought immediately.

Even if treated, serious damage can occur from a bite, and complications can always arise.

For another approach, see: Variable Bush Viper

Trimeresurus stejnegeri is a medically important snake species found in Taiwan, India, Nepal, southern China, Vietnam, and possibly Myanmar.

Its bite can induce serious symptoms, including tissue swelling, pain, thrombocytopenia, rhabdomyolysis, and acute renal failure.

More than 70% of the 1000 snake envenomations per year in Taiwan are caused by Trimeresurus stejnegeri and Protobothrops mucrosquamatus.

The Taiwan government produces the only globally available antivenom for Trimeresurus stejnegeri bites, which is recommended to be administered in amounts of 1 to 2 vials for envenomed patients.

For more insights, see: Trimeresurus Purpureomaculatus

The specific name of this species is a nod to its discoverer, Leonhard Stejneger, a Norwegian-born American herpetologist who dedicated over 60 years of his life to studying reptiles at the Smithsonian Institution.

Trimeresurus stejnegeri stejnegeri, also known as the green pit viper, is found in Taiwan, as well as India, Nepal, southern China, Vietnam, and possibly Myanmar.

This species is the only green pit viper in Taiwan, and its bite can be quite severe. The snake's venom can induce tissue swelling and pain, thrombocytopenia, rhabdomyolysis, and acute renal failure.

More than 70% of the 1000 snake envenomations per year in Taiwan are caused by Trimeresurus stejnegeri stejnegeri and Protobothrops mucrosquamatus.

The Taiwan government produces the only globally available antivenom for T. s. stejnegeri bites, and guidelines suggest administering 1 to 2 vials of specific antivenom to an envenomed patient.

However, these guidelines have not been scrutinized, and the severity of the symptoms caused by the snake's bite has not been well reported in previous studies.

The study population consisted of patients bitten by T. s. stejnegeri who were admitted to study hospitals from 2001 to 2016.

These patients were the focus of the study, which aimed to compare their characteristics, laboratory data, and management approaches with those who did not experience wound necrosis.

Patient characteristics were likely a key factor in the study, as the researchers sought to identify any differences between the two groups.

The study hospitals played a crucial role in collecting data from these patients, providing a comprehensive understanding of the effects of T. s. stejnegeri bites.

A total of 185 patients were evaluated in this study.

One patient died from coagulopathy and hemorrhagic shock.

Antivenom was administered to all envenomed patients at a median time of 1.8 hours after the bite.

The median total dose of antivenom was five vials.

Tissue swelling and pain, local ecchymosis, wound necrosis, coagulopathy, thrombocytopenia, rhabdomyolysis, and renal impairment were present in 182, 53, 13, 15, 10, 1, and 3 patients, respectively.

The main effects of T. s. stejnegeri envenomation are tissue swelling, pain, and local ecchymosis.

Using cold packs as first aid can actually be a risk factor for wound necrosis, so it's best to avoid them.

Bulla or blister formation can also increase the risk of subsequent wound necrosis, so patients should be carefully examined for this.

Antiplatelet use may worsen systemic bleeding, so it's something to be aware of.

Fortunately, severe rhabdomyolysis or renal failure were not prominent effects of T. s. stejnegeri bite in this large case series.

With treatment using specific antivenom, life-threatening bleeding is rare, and rhabdomyolysis and nephrotoxicity are not prominent consequences of T. s. stejnegeri envenomation.

Local swelling and pain were observed in all patients, with 28.6% experiencing local ecchymosis at the bite site, bullae or blisters, lymphadenitis or lymphangitis, local numbness, fever, and suspected wound infection.

In some cases, the bite site can become infected, with positive bacterial cultures noted in 6/12 patients from whom cultures were obtained. The identified organisms included Staphylococcus aureus, Staphylococcus hominis, Citrobacter freundii, Enterobacter cloacae, Morganella morganii, Pseudomonas aeruginosa, and an anaerobic Veillonella sp.

Most patients (87.4%) had a negative antivenom skin test, indicating no allergic reaction to the antivenom. However, some patients experienced allergic reactions, including anaphylaxis in 1.6% of patients and serum sickness in 5.5% of patients.

A total of 11 surgeries were performed, including debridement, fasciotomy, and skin grafts. The median hospital stay was 2.4 days, with operated patients staying for a median of 9.4 days compared to unoperated patients who stayed for 2.2 days.

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Local swelling and pain were observed in all patients except three who were asymptomatic.

Local ecchymosis at the bite site occurred in 28.6% of patients.

Bullae or blisters were observed in 11.9% of patients.

Lymphadenitis or lymphangitis was seen in 11.4% of patients.

Local numbness occurred in 10.8% of patients.

Fever was reported in 5.4% of patients.

Suspected wound infection was observed in 11.4% of patients.

Positive bacterial cultures were noted in 6/12 patients from whom cultures were obtained.

Seven organisms were identified, including Staphylococcus aureus, Staphylococcus hominis, Citrobacter freundii, and Pseudomonas aeruginosa.

Antibiotics administered before obtaining cultures included cefazolin, ceftriaxone, oxacillin, amoxicillin/clavulanic acid, clindamycin, and metronidazole.

A total of 182 patients were treated for Trimeresurus stejnegeri stejnegeri envenoming, with 13 cases of wound necrosis and 169 cases without wound necrosis.

The specific antivenom administration was not performed in 5 cases, with 159 cases having a negative antivenom skin test, 18 cases having a positive antivenom skin test, and 4 cases not having the test performed.

Anaphylaxis, skin rash, and serum sickness were reported in 3, 7, and 10 cases, respectively.

In most cases (92.9%), the first antivenom dose was administered within 6 hours of the bite, with a median time of 2.3 hours (IQR, 0.8-28.4) in cases with wound necrosis and 1.8 hours (IQR, 1.3-3.3) in cases without wound necrosis.

The total antivenom dose in vials was similar in both groups, with a median of 5 vials (IQR, 2-8) in cases with and without wound necrosis.

Surgical interventions were performed in 6 cases, including 5 debridements, 1 fasciotomy, and 2 split-thickness skin grafts or full-thickness skin grafts.

The median hospital stay was 2.4 days (IQR, 1.4-4 days) for all patients, with 2.2 days (IQR, 1.3-3.8 days) for unoperated patients and 9.4 days (IQR, 7.2-11.8 days) for operated patients.

Here is a summary of the surgical interventions:

Trimeresurus stejnegeri is a species of venomous snake, and understanding its abbreviations is crucial for medical professionals and researchers.

ACS stands for acute compartment syndrome, a condition that can be caused by snake bites.

The activated partial thromboplastin time, or aPTT, is a test used to evaluate the blood's ability to clot.

B. m. multicinctus is the scientific name for a species of snake venom.

Creatine kinase, or CK, is an enzyme found in the blood that can be elevated in response to muscle damage.

Deinagkistrodon acutus is another species of snake that can be found in the same region as Trimeresurus stejnegeri.

Enterobacter cloacae is a type of bacteria that can be found in the environment and can cause infections.

Fibrinogen equivalent unit, or FEU, is a measure of the clotting ability of the blood.

Full-thickness skin graft, or FTSG, is a type of surgical procedure that may be used to treat snake bite wounds.

The international normalized ratio, or INR, is a test used to evaluate the blood's ability to clot.

Naja atra is a species of snake that is venomous and can be found in the same region as Trimeresurus stejnegeri.

Odds ratio, or OR, is a statistical measure used to compare the risk of a disease or outcome between two groups.

Poison control center, or PCC, is a resource that can be used to seek advice on treating snake bites.

Protobothrops mucrosquamatus is a species of snake that is venomous and can be found in the same region as Trimeresurus stejnegeri.

Prothrombin time, or PT, is a test used to evaluate the blood's ability to clot.

Staphylococcus aureus is a type of bacteria that can cause infections.

Split-thickness skin graft, or STSG, is a type of surgical procedure that may be used to treat snake bite wounds.

Snake venom metalloproteinase, or SVMP, is a type of enzyme found in snake venom.

Snake venom serine protease, or SVSP, is a type of enzyme found in snake venom.

Thrombin-like enzyme, or TLE, is a type of enzyme found in snake venom.

Trimeresurus stejnegeri stejnegeri is the scientific name for a subspecies of the Trimeresurus stejnegeri snake.

The Taichung Veterans General Hospital, or VGH-TC, is a hospital that has treated patients with Trimeresurus stejnegeri bites.

The Taipei Veterans General Hospital, or VGH-TP, is a hospital that has treated patients with Trimeresurus stejnegeri bites.