Snake bites in the Arabian Peninsula, a review article

• The poisonous snakes in the Arabian Peninsula are of those with severe envenomations.
• The hemorrhagic types of toxins formed the majority of clinical effects.
• There are inappropriate first aid measures with delay in the use of antivenom.
• The rate and severity of complications are high.

Snake bites are an environmental hazard with significant morbidity and mortalities. The majority of snakes are non-poisonous and not all bites from poisonous snakes are associated with envenomation. There are variations in the types of snakes in different countries, and even within the same country, particularly across the different geographical regions with differences in climate. This variation is the case in the Arabian Peninsula. The most commonly reported snakes in this region are those that commonly cause death or severe disability by either shock, due to hemotoxins that exist in the majority of snake bites in this review, or respiratory failure due to neurotoxins. The types of poisonous snakes in the Arabian Peninsula and their effect are reviewed. Unlike land snakes, all sea snakes in the Gulf (consisting of approximately 11 species) are venomous and cause neuromuscular abnormalities leading to death from respiratory failure if they are not treated promptly. The incidence of death in the reviewed studies from the Arabian Peninsula showed great variation, from one patient a year, to 46 patients per year. The clinical features ranged from mild local manifestations to acute renal failure, cerebrovascular accidents (CVA), and death. Coagulopathy, leukocytosis, thrombocytopenia, and anemia are the main laboratory findings. The toxicity, pathophysiology, specific treatment with the supportive management, complications, and outcomes are discussed.