{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:39:40Z","timestamp":1793133580432,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:00:00Z","timestamp":1581033600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:00:00Z","timestamp":1581033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Hump-nosed viper bite, the commonest venomous snake bite in Sri Lanka, is associated with significant morbidity. Specific anti-venom is not available for hump-nosed viper envenomation which is usually managed with supportive treatment. Pulmonary haemorrhage is an unusual manifestation of hump-nosed viper bite. Here we present a case of hump-nosed viper envenomation which complicated by pulmonary haemorrhage and was successfully treated with systemic steroids. To the best of our knowledge, it has not been reported in the literature before.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A previously healthy 55-year-old man presented to the local hospital 18\u2009h after a hump-nosed viper bite. He developed bilateral severe pulmonary haemorrhages, evidenced by rapid desaturation which needed intubation and mechanical ventilation, bleeding from the endotracheal tube and bilateral alveolar shadows in a chest x-ray. He had no other bleeding manifestations. Because of the life-threatening situation, he was treated with methylprednisolone pulse therapy. There was a rapid improvement of hypoxia with a resolution of x-ray changes. He was successfully weaned off from the ventilation after 24\u2009h.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This case highlights the importance of suspecting pulmonary haemorrhage in a patient who develops desaturation and alveolar shadow following hump-nosed viper bite even in the absence of other bleeding manifestation. Early and timely treatment with systemic steroid can be lifesaving in such patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12890-020-1070-9","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T09:04:30Z","timestamp":1581066270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A life-threatening complication due to pulmonary haemorrhage following hump-nosed viper bite"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4905-6393","authenticated-orcid":false,"given":"Arthihai","family":"Srirangan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagath","family":"Pushpakumara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamani","family":"Wanigasuriya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,7]]},"reference":[{"issue":"3","key":"1070_CR1","first-page":"1","volume":"1","author":"KH Sellahewa","year":"2013","unstructured":"Sellahewa KH. 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J Venom Anim Toxins Incl Trop Dis. 2014;20:24.","journal-title":"J Venom Anim Toxins Incl Trop Dis"},{"issue":"11","key":"1070_CR4","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.trstmh.2008.03.023","volume":"102","author":"CA Ariaratnam","year":"2008","unstructured":"Ariaratnam CA, Thuraisingam V, Kularatne SAM, Sheriff MHR, Theakston RDG, de Silva A, et al. Frequent and potentially fatal envenoming by hump-nosed pit vipers (Hypnale hypnale and H. nepa) in Sri Lanka: lack of effective antivenom. Trans R Soc Trop Med Hyg. 2008;102(11):1120\u20136.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"1070_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11646\/zootaxa.2232.1.1","volume":"2232","author":"K Maduwage","year":"2009","unstructured":"Maduwage K. A taxonomic revision of the South Asian hump-nosed pit vipers. Zootaxa. 2009;2232:1\u201328.","journal-title":"Zootaxa"},{"key":"1070_CR6","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1016\/S1995-7645(10)60217-9","volume":"3","author":"HS Wijewantha","year":"2010","unstructured":"Wijewantha HS, Sellahewa KH. Hump nosed viper bite in Sri Lanka-descriptive observational study of 1543 cases. Asian Pacific J Trop Med. 2010;3:902\u20135.","journal-title":"Asian Pacific J Trop Med"},{"issue":"4","key":"1070_CR7","doi-asserted-by":"publisher","first-page":"725","DOI":"10.4269\/ajtmh.2009.09-0225","volume":"81","author":"CA Ariaratnam","year":"2009","unstructured":"Ariaratnam CA, Rezvi Sheriff MH, Arambepola C, Theakston RDG, Warrell DA. Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35"}}