Mamba envenomation in mainland France: Management of exotic envenomations needs rethinking

We report a case of accidental green mamba (Dendroaspis viridis) envenomation in the suburbs of Paris. Although moderate, neurotoxic symptoms were clearly present. Immunotherapy with polyvalent serum FAV-Afrique (R) was decided, but logistical problems prevented reasonably quick serum delivery to the hospital. Despite a spontaneously favourable outcome probably due to minimal envenomation, this case exemplifies a near-miss of the care system. Given the increasing incidence of potentially life-threatening exotic envenomations, management of similar cases should be improved. Besides breeders and health care professionals' information, we suggest that victims of an exotic envenomation be referred to a facility with experienced staff and ready access to a limited bank of carefully chosen antivenins. (c) 2008 Elsevier Masson SAS. Tous droits reserves.