Rapid development of a salivary calculus in submandibular gland and its potential causes in a young victim following Russell's viper bite. (30th January 2022)

• Record Type: Journal Article
• Authors: Arathisenthil, S.V.; Senthilkumaran, Subramanian; Vijayakumar, Pradeep; Savania, Ravi; Williams, Harry F.; Elangovan, Namasivayam; Bicknell, Andrew B.; Patel, Ketan; Trim, Steven A.; Thirumalaikolundusubramanian, Ponniah; Vaiyapuri, Sakthivel
• Is Part Of: Toxicon. Volume 206(2022)
• Page Start: 85
• Page End: 89
• Publication Date: 2022-01-30
• Subjects: Snakebite envenomation -- Russell's viper -- Salivary calculi -- Salivary glands -- Sialolithiasis -- Inflammation; Toxins -- Periodicals; Venom -- Periodicals; 615.9
• DOI: 10.1016/j.toxicon.2021.12.018
• Languages: English
• ISSNs: 0041-0101

Abstract

Abstract: Russell's viper bites are known to cause a range of haemotoxic, neurotoxic, myotoxic, cytotoxic and nephrotoxic complications. However, the impact of Russell's viper bites as well as bites from other venomous snakes on sialolithiasis has not been previously reported. Here, we present an interesting case where a Russell's viper bite induced the rapid development of a calculus in submandibular gland in a 10-year-old boy. Upon admission, the victim did not show any symptoms of swelling and/or pain around his oral cavity. He received antivenom treatment to normalise his coagulation parameters, however, on day three he developed swelling and extreme pain around his right mandibular region. An ultrasound investigation revealed the presence of a calculus in his submandibular gland, which was removed using a minor surgical procedure. The histopathological examination revealed this as a poorly calcified salivary calculus, which is composed of cell debris, mucopolysaccharides and lipids. The mechanisms behind its rapid development following a snakebite are unclear although this could be linked to excessive inflammation or modifications to the composition of saliva induced by venom toxins or other unknown factors. This report reveals an unusual complication induced by a Russell's viper bite and alerts clinicians who treat snakebites to be aware of such envenomation effects. Moreover, this will lead to novel research to explore the relationship between venom toxins and functions of salivary glands. Graphical abstract: Image 1 Highlights: Impact of snakebites on salivary calculi formation has not been previously reported. We report salivary calculus formation in a victim following Russell's viper bite. Venom might have caused excessive inflammation which led to calculus formation. The bite might have increased the pain from a previously developing calculus. Clinicians should be aware of this rare event when treating snakebite victims.