Chippaux Jean-Philippe auteur aut IRD Amta P. auteur aut IRD Madec Y. auteur aut IRD Ntone R. auteur aut IRD Noël G. auteur aut IRD Clauteaux P. auteur aut IRD Boum, Y., II auteur aut IRD Nkwescheu A. S. auteur aut IRD Taieb F. auteur aut IRD text journalArticle eng text/pdf reformatted digital access Background Species of the genus Echis, particularly those of the 'ocellatus' group, are responsible for the majority of snakebite envenomations and deaths in the savannas of sub-Saharan Africa. In a clinical study conducted in Cameroon, we treated a series of patients bitten by formally identified E. romani. The clinical outcomes are described and discussed.Methodology/Principal findings Specimens brought in by the victim were identified by a herpetologist. Clinical description and therapeutic management followed a standardized protocol applied by trained physicians. We included 92 patients, 95% of whom (n = 87) were envenomated. More than one third of the bites occurred during agricultural work, and one quarter in the victim's home. The bite site was the foot in 48 victims (52%) and the hand in 40 others (43%), mostly children and teenagers. Cytotoxic syndrome was observed in 84 of the 87 envenomated patients (97%). Hemostasis disorders were observed in 78 patients (90%), 38 of whom (44%) experienced bleeding during hospitalization. In 5 of the latter (13%), the bleeding recurred, whereas it had stopped after antivenom administration. A further 7 patients, who were not bleeding on arrival, experienced late bleeding despite antivenom administration. Four patients (4.3%), including one pregnant woman, died. All were bleeding on arrival. Finally, 2 patients (2.2%) had permanent sequelae of moderate severity.Methodology/Principal findings Specimens brought in by the victim were identified by a herpetologist. Clinical description and therapeutic management followed a standardized protocol applied by trained physicians. We included 92 patients, 95% of whom (n = 87) were envenomated. More than one third of the bites occurred during agricultural work, and one quarter in the victim's home. The bite site was the foot in 48 victims (52%) and the hand in 40 others (43%), mostly children and teenagers. Cytotoxic syndrome was observed in 84 of the 87 envenomated patients (97%). Hemostasis disorders were observed in 78 patients (90%), 38 of whom (44%) experienced bleeding during hospitalization. In 5 of the latter (13%), the bleeding recurred, whereas it had stopped after antivenom administration. A further 7 patients, who were not bleeding on arrival, experienced late bleeding despite antivenom administration. Four patients (4.3%), including one pregnant woman, died. All were bleeding on arrival. Finally, 2 patients (2.2%) had permanent sequelae of moderate severity.Conclusion/Significance This study confirms the frequency and severity of hemorrhagic complications in E. romani envenomation. Lethality remains high despite antivenom treatment. Cytotoxic syndromes, present in 95% of victims, rarely progress to extensive necrosis. specialized CAMEROUN AFRIQUE SUBSAHARIENNE 050 080 19 7 e0013195 [18 ] 2025 1935-2735 https://www.documentation.ird.fr/hor/fdi:010094797 10.1371/journal.pntd.0013195 1935-2735 [F B010094797] https://www.documentation.ird.fr/hor/fdi:010094797 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-09/010094797.pdf IRD - Base Horizon / Pleins textes 2025-09-24 2025-11-04 fdi:010094797 fre