Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Antivenom treatment for snakebite envenoming

Nature Reviews Disease Primers volume 10, Article number: 59 (2024) Cite this article

Subjects

Venomous snakes are widely distributed in the world and snakebite envenoming is a medical emergency with high fatality and disability rates1,2. Rapid identification and assessment of the patients affected by venomous snakebite, and accurate and timely medical decision-making are crucial to save the lives of these patients. In their article, Gutiérrez and colleagues have comprehensively elaborated the epidemiology, clinical manifestations, assessment and treatment strategies of snakebite envenoming (Gutiérrez, J. M. et al. Snakebite envenoming. Nat. Rev. Dis. Primers 3, 17063 (2017))3. However, after careful literature review, I believe that some supplements need to be made in terms of the indication of antivenom treatment1,2,3.

Antivenom is the only specific treatment for snakebite envenoming. Monovalent serums are often given to victims of venomous snakebites of known species, and polyvalent antivenoms or a combination of multiple monovalent serums are often required for envenomation by unknown venomous snakes1,2. In their article, the authors list the clinical indications in patients that warrant antivenom administration, including systemic and local manifestations3. However, it should be noted that the development of an enlarged tender lymph node draining the bitten limb is also a clinical indication for antivenom administration, as per the 2016 WHO guidelines1,2. This indication should not be ignored as snake venom can spread through lymphatic routes in addition to blood3,4,5,6.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. WHO Regional Office for South-East Asia. Guidelines for the management of snakebites 1st edn (WHO, 2010).

  2. WHO Regional Office for South-East Asia. Guidelines for the management of snakebites 2nd edn (WHO, 2016).

  3. Gutiérrez, J. M. et al. Snakebite envenoming. Nat. Rev. Dis. Primers 3, 17063 (2017).

    Article  PubMed  Google Scholar 

  4. Evans, D. D. & Nelson, L. W. Treating venomous snakebites in the United States: a guide for nurse practitioners. Nurse Pract. 38, 13–22 (2013).

    Article  PubMed  Google Scholar 

  5. Mora, J., Mora, R., Lomonte, B. & Gutiérrez, J. M. Effects of Bothrops asper snake venom on lymphatic vessels: insights into a hidden aspect of envenomation. PLoS Negl. Trop. Dis. 2, e318 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  6. van Helden, D. F., Dosen, P. J., O’Leary, M. A. & Isbister, G. K. Two pathways for venom toxin entry consequent to injection of an Australian elapid snake venom. Sci. Rep. 9, 8595 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Emergency Department, Chongqing University Fuling Hospital, School of Medicine, Chongqing University, Chongqing, China

    Jin-Long Wang

Authors
  1. Jin-Long Wang
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Jin-Long Wang.

Ethics declarations

Competing interests

The author declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, JL. Antivenom treatment for snakebite envenoming. Nat Rev Dis Primers 10, 59 (2024). https://doi.org/10.1038/s41572-024-00543-9

Download citation

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41572-024-00543-9

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing