Severe Anaphylactic Shock Following a Slow Loris Bite in a Patient with Cat Allergy

Slowly Making Sense: A Review of the Two-Step Venom System within Slow (Nycticebus spp.) and Pygmy Lorises (Xanthonycticebus spp.)

Since the early 2000s, studies of the evolution of venom within animals have rapidly expanded, offering new revelations on the origins and development of venom within various species. The venomous mammals represent excellent opportunities to study venom evolution due to the varying functional usages, the unusual distribution of venom across unrelated mammals and the diverse variety of delivery systems. A group of mammals that excellently represents a combination of these traits are the slow (Nycticebus spp.) and pygmy lorises (Xanthonycticebus spp.) of south-east Asia, which possess the only confirmed two-step venom system. These taxa also present one of the most intriguing mixes of toxic symptoms (cytotoxicity and immunotoxicity) and functional usages (intraspecific competition and ectoparasitic defence) seen in extant animals. We still lack many pieces of the puzzle in understanding how this venom system works, why it evolved what is involved in the venom system and what triggers the toxic components to work. Here, we review available data building upon a decade of research on this topic, focusing especially on why and how this venom system may have evolved. We discuss that research now suggests that venom in slow lorises has a sophisticated set of multiple uses in both intraspecific competition and the potential to disrupt the immune system of targets; we suggest that an exudate diet reveals several toxic plants consumed by slow and pygmy lorises that could be sequestered into their venom and which may help heal venomous bite wounds; we provide the most up-to-date visual model of the brachial gland exudate secretion protein (BGEsp); and we discuss research on a complement component 1r (C1R) protein in saliva that may solve the mystery of what activates the toxicity of slow and pygmy loris venom. We conclude that the slow and pygmy lorises possess amongst the most complex venom system in extant animals, and while we have still a lot more to understand about their venom system, we are close to a breakthrough, particularly with current technological advances.

Animal bite anaphylaxis, rarely diagnosed but underappreciated

BACKGROUND

Animal allergies are common, with reactions ranging from rhinoconjunctivitis from respiratory exposure to anaphylaxis, usually from animal bites. Since animal bites are also common, this raises the question of how often anaphylaxis occurs following a bite.

MATERIALS AND METHODS

A PubMed, Google, and Google Scholar literature review was performed using keywords such as animal bite anaphylaxis. An inquiry was made to the Anaphylaxis Registry ANAPHYLAXIE.net to see if additional cases were contained in the registry.

RESULTS

Approximately 40 cases of animal bite anaphylaxis are described in the literature, mostly from rodent bites (mice, rats, hamsters, and guinea pigs). A survey of laboratory animal bite anaphylaxis in the U.S. identified previously unreported cases, suggesting that most cases are not reported.

CONCLUSION

Anaphylaxis from animal bites is rarely reported, but occurs more frequently than suggested by case reports and should be considered in a symptomatic patient following a bite.

Effects of a Bengal Slow Loris Nycticebus bengalensis (Primates: Lorisidae) bite: a case study from Murlen National Park, Mizoram, India

Lorisids are the only known venomous primates. Threatened by habitat loss and pet trade, lorises and the effects of their bite, have received little attention to date. Given the growing number of accounts of bites by lorises on humans and paucity of information on their venom, here we present a case study on the context and results of a Bengal Slow Loris bite that occurred in the vicinity of Murlen National Park, Mizoram, India.