Sanjib Kumar Sharma, Emilie Alirol, Anup Ghimire, Suman Shrestha, Rupesh Jha, Surya B Parajuli, Deekshya Shrestha, Surya Jyoti Shrestha, Amir Bista, David Warrell, Ulrich Kuch, Francois Chappuis, Walter Robert John Taylor
Diagnosing and treating acute severe and recurrent antivenom-related anaphylaxis (ARA) is challenging and reported experience is limited. Herein, we describe our experience of severe ARA in patients with neurotoxic snakebite envenoming in Nepal. Patients were enrolled in a randomised, double-blind trial of high vs. low dose antivenom, given by intravenous (IV) push, followed by infusion. Training in ARA management emphasised stopping antivenom and giving intramuscular (IM) adrenaline, IV hydrocortisone, and IV chlorphenamine at the first sign/s of ARA...
2019: Journal of Tropical Medicine