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I morsi di vipera

Viper bites are rare but represent a medical emergency that should not be underestimated both in the paediatric and adult population. The clinical presentation can vary from mild symptoms limited to the venom inoculation site to serious cases with extensive tissue involvement and with systemic neurological, haematologic, renal and cardiovascular symptoms. Immediate hospitalization with clinical monitoring is required to promptly undertake the therapy with antivenom serum, when needed, in order to avoid complications related to the venom’s toxicity. In the literature there are no recent and standardised guidelines on viper bite management and treatment. The paper presents a case-series of four children brought to the Emergency Department for viper bite. The peculiarity of the reported cases is that they were all observed in the first 20 days of May 2020, immediately after the end of the lockdown for Covid-19 pandemic. This could be explained by the effect of prolonged lockdown on animal and viper re-expansion in areas with usually larger human presence. The aim of this article is to present the latest literature updates and provide clear and simple indications for the diagnosis, monitoring and therapy of paediatric viper bite to improve its management and prognosis.