WCH Clinical Toxinology Resources

Necrotoxins_Overview

Necrotoxins

Local tissue injury around the bite site is a common feature of Viperid bites, though not all vipers cause local necrosis. However, certain Elapids, notably some cobra species from Africa and SE Asia, routinely cause local necrosis. In most cases the venom components causing this damage are incompletely understood, though the ubiquitous phospholipase A2 toxins are thought to have a major role. The misnamed “cobratoxins” also cause local tissue injury.

Snakes known to potentially cause significant local tissue injury and necrosis at the bite site.

Scientific name	Common name	Effect
ELAPIDAE
Naja spp.	Selected cobras, especially spitting cobras	Local blistering through to extensive deep necrosis
Ophiophagus hannah	King cobra	Occasional local necrosis
LAMPROPHIIDAE	(Sub-family Atractaspidinae)
Atractaspis spp.	Mole or side fanged vipers	A few species only cause local tissue injury, occasionally necrosis
VIPERIDAE
Agkistrodon spp.	Cottonmouth, copperhead, cantil	Local blistering through to necrosis
Atropoides spp.	Jumping pit vipers	Local blistering through to necrosis
Bitis spp.	Puff adder, Gaboon viper etc	Local blistering through to extensive deep necrosis
Bothriechis spp.	Palm pit vipers	Local blistering through to extensive deep necrosis
Bothrops spp.	Lancehead vipers	Local blistering through to extensive deep necrosis
Calloselasma rhodostoma	Malayan pit viper	Local blistering through to extensive deep necrosis
Causus spp.	Night adders	Local blistering through to necrosis
Cerastes spp.	Horned adders	Local blistering through to necrosis
Cerriphidion spp.	Montane pit vipers	Local blistering through to necrosis
Crotalus spp.	Rattlesnakes	Nth American spp.; local blistering through to extensive deep necrosis
Daboia russelii	Russell’s viper	Local blistering through to extensive deep necrosis
Deinagkistrodon acutus	Hundred pace viper	Local blistering through to extensive deep necrosis
Hypnale spp.	Hump nosed vipers	Local blistering through to necrosis
Echis spp.	Saw scaled vipers	Local blistering through to extensive deep necrosis
Lachesis spp.	Bushmasters	Local blistering through to extensive deep necrosis
Ophryacus spp.	Horned pit vipers	Local blistering through to necrosis
Porthidium spp.	Montane pit vipers	Local blistering through to necrosis
Sistrurus spp.	Massasauga, pygmy rattlesnake	Local blistering through to necrosis (uncommon)
Trimeresurus spp.	Green tree pit vipers	Local blistering through to necrosis (selected species only)

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