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Table 3 Description, characteristics, and response to initial antivenom therapy in 17 patients with abnormal WBCT results

From: Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation

Case n. WBCT20 ≠ WBCT30 Sex Age Snake species Delay (hours) Stage of edema/bleeding HCT at H0 (%) N. vials AA at Ha Initial WBCT20 at H0 Initial WBCT30 at H0 1st Normal WBCT20 at Ha 1st Normal WBCT30 at Ha External bleeding arrested at Ha
1 Group 3a Group 4 M 7 Echis 72 E5, B4 24.4 H0 = 2 H3 = 2 No clot No clot H3 H3 H6
2 Group 2 M 9 Echis 12 E3, B5 13.0 H0 = 2 No clot No clot H24 H48 H3
3 Group 2 Group 3b M 7 Echis 24 E2, B3 40.0 H0 = 2 No clot No clot H12 H6 H3
4 Group 1 M 42 Bitis 20 E5, B1 31.0 H0 = 2 Weakly friable Improved friable H3 H3 H3
5 Group 2 Group 4 M 15 Echis 48 E5, B5 14.0 H0 = 2 H6 = 2 No clot No clot H3 H6 H12
6   M 25 Echis 192 E2, B4 31.6 H0 = 2 No clot No clot H3 H3 H3
8   M 41 Echis 120 E1, B4 42.0 H0 = 2 No clot No clot H3 H3 H3
10 Group 3a Group 4 M 18 Echis 96 E2, B5 21.0 H0 = 2 H3 = 2 No clot No clot H6 H6 H12
12 Group 3a M 25 Echis 1 E1, B3 35.0 H0 = 2 H3 = 2 No clot No clot H6 H6 H6
13 Group 2 M 20 Echis 72 E3, B4 36.0 H0 = 2 No clot No clot H3 H24 H3
a15 Group 1 F 18 Bitis 72–168 E1, B1 32.3 H0 = 1 Friable Normal H3 N/A Before arrival
b17 Group 1 M 30 Echis 120 E2, B5 39.0 H0 = 2 Friable No clot H3 H3 Internal only
18   M 25 Echis 4 E2, B3 N/A H0 = 2 No clot No clot H3 H3 H3
19 Group 2 F 15 Echis 72 E3, B5 24.0 H0 = 2 No clot No clot H3 H6 H3
20 Group 2 M 35 Echis 3 E1, B4 36.0 H0 = 2 H3 = 2 No clot No clot H24 H72 H6
c22 Group 3b F 12 Echis 24 E2, B5 11.0 H0 = 2 No clot No clot H6 H6 H3
23 Group 2 M 22 Echis 69 E2, B5 11.0 H0 = 2 No clot No clot H6 H24 H3
  1. a15 = Patient alternately stated that the bite occurred either 3 or 7 days earlier; abnormal local bleeding reportedly began 48 h after the bite but resolved shortly before she came to the hospital. Freshly dried blood was visible around the bite site
  2. b17 = Hematemesis and gingival bleeding resolved shortly before arrival, but he presented with gross hematuria and signs of subarachnoid hemorrhage (widening pulse pressure with systolic hypertension; bradycardia; irregular breathing; altered mental status). Signs of increased intracranial pressure resolved between H12 and H24. There was still gross hematuria when the patient discharged himself against medical advice at H144, but the overall clinical picture suggested that kidney injury rather than active venom was causing the issue at the time of discharge
  3. c22 = Gingival bleeding stopped after antivenom at H0. No WBCT taken at H3, but WBCT20 and WBCT30 were both normal at H6