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. 2023 Jun 17;7(2):e168–e183. doi: 10.1055/s-0043-1769625

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The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ )

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 1 — The offending Russell's viper specimens and local envenoming effects in victims. ( A ) The offending snake species of the first patient was identified as Russell's viper by a herpetologist. ( B ) Russell's viper bite induced bleeding at the bite site and swelling and discoloration of the right arm of the first patient. ( C ) The offending snake species which was confirmed as Russell's viper for the second patient ( D ), who displayed gangrenous digits (including the index finger where the bite occurred) in their right hand. The specimen of Russell's viper ( E ), which bit the third patient at the nape of the neck and caused local bleeding ( F ).