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Reptiles En Tant Que Nac Et Risques Sanitaires Associes

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Reptiles En Tant Que Nac Et Risques Sanitaires Associes UNIVERSITE TOULOUSE III PAUL SABATIER FACULTE DES SCIENCES PHARMACEUTIQUES ANNEE : 2014 THESES 2014 TOU3 2016 THESE POUR LE DIPLOME D'ETAT DE DOCTEUR EN PHARMACIE Présentée et soutenue publiquement par BOCQUILLON LIGER-BELAIR BENOÎT, GUY, PIERRE REPTILES EN TANT QUE NAC ET RISQUES SANITAIRES ASSOCIES Soutenue le Lundi 31 Mars 2014 Directeur de thèse : Pr Valentin Alexis JURY Président : Valentin Alexis 1er assesseur : Paloque Lucie 2ème assesseur : Amouroux Noel A ma fille Léanne et ma compagne Marie-Charlotte, Vous avez chamboulé ma vie et changé toutes mes perspectives, je vous aime. A ma famille et plus particulièrement mon père, Qui m’ont soutenu tout au long de mes études et sans qui je ne serai peut pas pharmacien aujourd’hui. A Mr le professeur Alexis Valentin, Praticien hospitalier en Parasito-Mycologie et professeur à la Faculté des Sciences Pharmaceutiques de Toulouse, pour m’avoir guidé tout au long de ce travail et qui me fait l’honneur d’être le président de mon jury. A Mr Noël Amouroux, Pharmacien attaché au Centre AntiPoison de Toulouse et professeur à la Faculté des Sciences Pharmaceutique, qui me fait l’honneur de participer à mon jury de thèse ainsi que pour ses conseils et contacts. A Mlle Lucie Paloque, Attaché Temporaire d’enseignement et de recherche à la Faculté des Sciences Pharmaceutique, qui me fait aussi l’honneur de participer à mon jury de thèse. Je tiens aussi à remercier tout ceux qui m’ont aidé et ont répondu à mes interrogations sur ce travail et ainsi permis de mettre un point final à mes études : Le Dr Luc De Haro, spécialiste des NAC au Centre AntiPoison de Marseille et attaché à la BSA. Mr Pierre Quistinic, Président de la BSA et du Terrarium de Kerdanet. Le Dr Christophe Pasquier, Professeur de virologie-bactériologie, Doyen de la Faculté des Sciences Pharmaceutiques et Virologiste au CHU de Toulouse, INSERM. Le Dr Boris Rabot, vétérinaire à la clinique des NAC de L’ENVT. Mr Stéphane Bertagnoli, Professeur de virologie à l’École Nationale Vétérinaire de Toulouse, INRA- ENVT. Mme Florence Taboulet, professeur à la Faculté des Sciences Pharmaceutique de Toulouse. TABLE DES MATIERES 1 PRINCIPAUX REPTILES RENCONTRES EN TANT QUE NAC .............................................................. 10 1.1 Eléments de systématique ........................................................................................................ 10 1.2 Principaux sauriens ................................................................................................................... 18 1.2.1 L’iguane vert .................................................................................................................. 18 1.2.2 Les agames et basilics .................................................................................................... 19 1.2.3 Les téjus et les varans .................................................................................................... 21 1.2.4 Les geckos ...................................................................................................................... 24 1.2.4.1 Les geckos diurnes ..................................................................................................... 24 1.2.4.2 Les uroplates ............................................................................................................. 25 1.2.4.3 Les geckos léopards ................................................................................................... 25 1.2.5 Les caméléons ............................................................................................................... 27 1.3 Principaux ophidiens ................................................................................................................. 29 1.3.1 Les boïdés ...................................................................................................................... 29 1.3.1.1 Les pythons ................................................................................................................ 29 1.3.1.2 Les boas ..................................................................................................................... 31 1.3.1.3 Les anacondas ........................................................................................................... 32 1.3.2 Les colubridés ................................................................................................................ 33 1.3.2.1 Les élaphes ................................................................................................................ 33 1.3.2.2 Les Lampropeltis ........................................................................................................ 34 1.3.2.3 Les autres colubridés ................................................................................................. 35 1.4 Principaux chéloniens................................................................................................................ 35 1.4.1 Les tortues terrestres .................................................................................................... 35 1.4.1.1 Les tortues de Méditerranée ..................................................................................... 35 1.4.1.2 Les tortues exotiques ................................................................................................ 37 1.4.2 Les tortues aquatiques .................................................................................................. 39 1.4.2.1 Les tortues semi-aquatiques exotiques ..................................................................... 39 1.4.2.2 Les tortues aquatiques sauvages de France .............................................................. 41 1.5 Principaux crocodiliens.............................................................................................................. 41 2 RISQUES INHERENTS A LA POSSESSION DE REPTILES.................................................................... 46 2.1 La fonction venimeuse .............................................................................................................. 46 2.1.1 Appareil venimeux ......................................................................................................... 47 2.1.2 Venins ............................................................................................................................ 49 1 2.1.3 Envenimations ............................................................................................................... 50 2.1.4 Conduite à tenir face à une morsure ............................................................................. 52 2.1.4.1 Attitude de la personne mordue ............................................................................... 52 2.1.4.2 Attitude du pharmacien ............................................................................................ 52 2.1.4.3 Attitude médicale ...................................................................................................... 53 2.1.4.4 Attitude dans le cas d’une consultation vétérinaire ................................................. 54 2.1.5 Règles de maintient en captivité ................................................................................... 55 2.1.6 Fabrication d’un sérum antivenimeux........................................................................... 57 2.1.7 Banque de Sérums Antivenimeux ................................................................................. 58 2.1.7.1 Historique et cadre réglementaire ............................................................................ 58 2.1.7.2 Organisation et objectifs ........................................................................................... 59 2.1.7.3 Les sérums antivenimeux .......................................................................................... 60 2.2 Zoonoses transmises par l’intermédiaire des reptiles .............................................................. 62 2.2.1 Zoonoses bactériennes .................................................................................................. 62 2.2.1.1 Salmonellose ............................................................................................................. 62 2.2.1.1.1 Etiologie ............................................................................................................... 62 2.2.1.1.2 Epidémiologie ...................................................................................................... 63 2.2.1.1.3 Symptômes chez les reptiles ............................................................................... 64 2.2.1.1.4 Symptômes chez l’Homme .................................................................................. 65 2.2.1.1.5 Traitement et prophylaxie ................................................................................... 65 2.2.1.2 L’aéromonose ............................................................................................................ 66 2.2.1.2.1 Etiologie ............................................................................................................... 66 2.2.1.2.2 Epidémiologie ...................................................................................................... 66 2.2.1.2.3 Symptômes chez les reptiles ............................................................................... 67 2.2.1.2.4 Symptômes chez l’Homme .................................................................................. 68 2.2.1.2.5 Traitement et prophylaxie
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