{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:20:55Z","timestamp":1777501255310,"version":"3.51.4"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Trimeresurus gracilis<\/jats:italic> is a pit viper inhabiting the high mountains of Taiwan. No specific antivenom against <jats:italic>T. gracilis<\/jats:italic> is available, and we did not find any prior published case reports on its clinical envenomation. We present two patients with <jats:italic>T. gracilis<\/jats:italic> envenomation who were both bitten on the index finger and were administered bivalent hemotoxic antivenom against <jats:italic>Trimeresurus stejnegeri<\/jats:italic> and <jats:italic>Protobothrops mucrosquamatus<\/jats:italic>. In case 1, the patient was administered seven vials of antivenom within 2 days of envenomation. She received surgical intervention on day 26 and recovered from the wound 3 months after envenomation, but her left index finger was slightly and irreversibly bent. In case 2, the patient was administered 12 vials of antivenom within 10 hours after envenomation, received surgical intervention on day 1, and underwent debridement and reconstruction surgery on day 7 after envenomation. The wounds healed 1.5 months after envenomation, and no deformity occurred. Laboratory data showed elevated D-dimer levels and prothrombin times. The cross-neutralizing ability of bivalent hemotoxic antivenom against <jats:italic>T. stejnegeri<\/jats:italic> and <jats:italic>P. mucrosquamatus<\/jats:italic> appeared insufficient to treat the local effects of <jats:italic>T. gracilis<\/jats:italic> envenomation. The deformity of the finger of the patient in case 1 might have been caused by the lower dose, later administration of antivenins, and a delay in the necessary surgery.<\/jats:p>","DOI":"10.4269\/ajtmh.21-1144","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T15:49:21Z","timestamp":1644248961000},"page":"1281-1284","source":"Crossref","is-referenced-by-count":9,"title":["Case Report: Symptoms and Prognosis of Trimeresurus gracilis Envenomation"],"prefix":"10.4269","volume":"106","author":[{"given":"Tein-Shun","family":"Tsai","sequence":"first","affiliation":[{"name":"1Department of Biological Science and Technology, National Pingtung University of Science and Technology, Pingtung, Taiwan, Republic of China;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuen Ying","family":"Chan","sequence":"additional","affiliation":[{"name":"1Department of Biological Science and Technology, National Pingtung University of Science and Technology, Pingtung, Taiwan, Republic of China;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szu-Mien","family":"Huang","sequence":"additional","affiliation":[{"name":"2Kaohsiung Municipal San Min Junior High School, Kaohsiung, Taiwan, Republic of China;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Chun","family":"Chuang","sequence":"additional","affiliation":[{"name":"3Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/4\/article-p1281.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/4\/article-p1281.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T12:38:30Z","timestamp":1649248710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/4\/article-p1281.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,6]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-1144","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,6]]}}}