{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T21:54:23Z","timestamp":1775598863574,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Most cases of envenomation by common European vipers (Vipera berus) have not been reported to have neurotoxic manifestations. However, these manifestations have been demonstrated in some cases of envenomation by subspecies of V. berus, found in the Carpathian Basin region of south-eastern Europe. Here, we report the case of a 5-year-old girl from the south of Romania who presented symptoms of neurotoxicity, as well as other systemic and local symptoms, after being bitten by an adder of the V. berus subspecies. Treatment consisted of monovalent antivenom, a corticosteroid, and prophylactic enoxaparin. Neurotoxic manifestations of envenomation as well as other local and systemic symptoms improved within 5 days of treatment. The presented case shows that venom from V. berus subspecies found in the Carpathian Basin can have neurotoxic effects. This case also confirmed the efficacy of monospecific antivenom treatment in bringing about rapid and complete remission, following envenomation.<\/jats:p>","DOI":"10.3390\/toxins14070500","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T00:19:21Z","timestamp":1658189961000},"page":"500","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neurotoxicity and Other Clinical Manifestations of a Common European Adder (Vipera berus) Bite in Romania"],"prefix":"10.3390","volume":"14","author":[{"given":"Gabriela Viorela","family":"Ni\u021bescu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cGrigore Alexandrescu\u201d, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Coriolan Emil","family":"Ulmeanu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cGrigore Alexandrescu\u201d, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-7730","authenticated-orcid":false,"given":"Maria-Dorina","family":"Cr\u0103ciun","sequence":"additional","affiliation":[{"name":"Emergency Clinical Hospital for Children \u201cGrigore Alexandrescu\u201d, 011743 Bucharest, Romania"},{"name":"Department of Epidemiology, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina Maria","family":"Ciuc\u0103","sequence":"additional","affiliation":[{"name":"Emergency Clinical Hospital for Children \u201cGrigore Alexandrescu\u201d, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-1506","authenticated-orcid":false,"given":"Alexandru","family":"Ulici","sequence":"additional","affiliation":[{"name":"Emergency Clinical Hospital for Children \u201cGrigore Alexandrescu\u201d, 011743 Bucharest, Romania"},{"name":"Department of Pediatric Surgery and Orthopedics, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioan","family":"Ghira","sequence":"additional","affiliation":[{"name":"Romanian Association of Herpetology, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-3445","authenticated-orcid":false,"given":"Davide","family":"Lonati","sequence":"additional","affiliation":[{"name":"Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, IRCCS, Maugeri Foundation, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3897\/zookeys.341.5502","article-title":"Diversity and distribution of reptiles in Romania","volume":"341","author":"Rozylowicz","year":"2013","journal-title":"Zookeys"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.toxicon.2015.09.039","article-title":"European viper envenomation recorded by French poison control centers: A clinical assessment and management study","volume":"108","author":"Jollivet","year":"2015","journal-title":"Toxicon"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1080\/15563650.2021.1891245","article-title":"Moderate-to-severe Vipera berus envenoming requiring ViperaTAb antivenom therapy in the UK","volume":"59","author":"Lamb","year":"2021","journal-title":"Clin. 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