Wound infection secondary to snakebite (original) (raw)
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Wound infections secondary to snakebite
The Journal of Infection in Developing Countries, 2009
Background: The study was performed to identify the important bacterial pathogens responsible for wound infections secondary to snakebite and to determine their antimicrobial susceptibility. Methodology: All cases of wound infection secondary to snakebite were included in this retrospective study. Infected tissues were surgically debrided and inoculated on blood agar and MacConkey agar for aerobic bacterial culture, followed by antimicrobial susceptibility testing of the isolates by Kirby-Bauer disk diffusion method. Results: Staphylococcus aureus (32%) was the most common isolate followed by Escherichia coli (15%); monomicrobial infections were more frequent than polymicrobial infections. The majority of the isolates were antibiotic sensitive. Ciprofloxacin, an oral drug covering both Gram-positive and Gram-negative isolates, was the most frequently prescribed antibiotic. The patients responded well to the treatment. Conclusion: The results of this study will be helpful in deciding the empirical antibiotic therapy in cases of wound infection secondary to snakebite in regions of Southeast Asia.
Snakebites on Distal Extremities; Three Years of Experiences
Zahedan Journal of Research in Medical Sciences
Background: Globally, 1.5 to 3 million people are exposed to snakebites each year. More than 100,000 of these cases, primarily in the tropics, result in death. This study includes an analysis of a university hospital's three-year experiences of distal extremity snakebites. Methods: This study includes 68 patients presented at the Emergency Department (ED) of Gaziantep University Hospital with snakebites on distal extremities (hands, fingers, and feet) between 01/03/2014 and 01/03/2017. Results: A total of 68 patients had wet snakebites on their distal extremities. Forty-seven patients (69%) were male, 21 (30.9%) were female, and the mean age was 43.03 ± 18.13 years. Snakebites most commonly occurred in September (26.5%, n = 18). Twenty-five (36.76%) patients had systemic symptoms (grades 2, 3, and 4). Also, 98.5% (n = 67) of patients received only antivenom therapy. Compartment syndrome was observed in one patient (1.5%), and this patient was treated with antivenom therapy and p...
Snakebite Injuries Treated in United States Emergency Departments, 2001–2004☆
Wilderness & Environmental Medicine, 2007
Objective.-Venomous and nonvenomous snakes are found throughout most of the United States. While the literature on treatment is robust, there is not a current national epidemiologic profile of snakebite injuries in the United States. National estimates of such injuries treated in emergency departments (EDs) are presented along with characteristics of the affected population.
RSTMH Special Report on Snakebite
2019
To mark International Snakebite Awareness Day on Thursday 19 September, RSTMH is publishing a report on community groups from around the world who are currently leading the fight against snakebites locally, as well as hosting a day of events at the European Congress on Tropical Medicine and International, which we are hosting in Liverpool
Clinical characteristics of children with snakebite poisioning
Background : Venomous snakebite is an emergency condition with high morbidity and mortality in childhood. Nearly all venomous snakes in Turkey are members of the Viperidae family and show poisonous local and hematotoxic effects. Methods : A total of 77 children (mean age 9.9 ± 2.9 years; age range 3-14 years) with venomous snakebites were investigated. General characteristics of the children, species of the snakes, localization of the bite, clinical and laboratory findings, treatment approaches, complications and prognosis were evaluated. Results : The male to female ratio was 1.4. Ninety-one per cent of cases were from rural areas. Most of the bites were seen in May and June. Mean duration between snakebites and admissions to our department was 13 ± 6.5 h. According to a clinical grading score, 57.1% of patients presented to us as grade II. Mean leukocyte count, aspartate aminotransferase, lactate dehydrogenase, creatinine phosphokinase and protrombin time levels were above the normal ranges and mean activated partial tromboplastin time was below the normal range. Platelet counts inversely correlated with the grading score and duration of hospitalization. The most common complication that occurred during the treatment was tissue necrosis (13%). The mean hospital stay time was 6.3 ± 6 days. Three children with disseminated intravascular coagulation died. Fasciotomies were performed to seven (9.1%) children due to compartment syndrome. Of 10 children with tissue necrosis, three (3.9%) had finger amputation and seven (9.1%) had toe amputation. Higher grading score on admission, platelet count below 120 000/mm 3 , AST over 50 IU/L and existence of evident ecchymosis were found as significant risk factors for development of serious complications by logistic regression analysis. Conclusions : Snakebite poisoning is an emergency medical condition that is particularly important in childhood. The envenomations are still considerable public health problems with a high morbidity and mortality in rural areas of Turkey.
Clinical Profile and Outcomes of Snakebite Envenomation in Fayoum Governorate, Egypt
The Egyptian Journal of Forensic Sciences and Applied Toxicology
Objectives: Snakebite is an extreme medical emergency requiring convenient intercession. Snakebite victims and medical care providers assumed a vital role in determining snake type. Two toxic species are widespread in Egypt; the family Viperidae (snakes) and the family Elapidae (Egyptian copra: Naja Haje). The work aims to map out the sociodemographic characteristics, patterns, the profile of clinical manifestations, possible predictors of severity, and the outcomes for snakebite patients admitted to Fayoum general hospital. Methods: This study was carried out at Fayoum general hospital from May 2018 to May 2020. In each case, sociodemographic data, poisoning data (delay time, site of bite and type of snake), clinical data (local and systemic manifestations and post-snakebite complications), laboratory data (CBC, PT, INR), grading of the envenomation severity (Grade 0no envenomation, Grade 1mild envenomation, Grade 2moderate envenomation, Grade 3severe envenomation), anti-snake venom vials (ASV), and outcomes of the patients (survived, non-survived and referred) had recorded. Data were collected and coded for statistical analysis. Results: Males outnumbered females (85.7% versus 14.3%), and the mean age of patients was 32.31 years. 85.7% were living in rural places, presented commonly during the summer season (68.6%), the mean delay time was 5.89 hours, the mean duration of hospitalization was 5.13 days, and the mean ASV was 16.71±7.760 for each patient till discharge. 60% was Viper's snake. The lower limb was the most familiar sight of the bite (57.2%). There was a highly significant difference between the outcomes of patients and the delayed time of presentation to the hospital, prothrombin time, and INR. The mortality rate was 8.6%. Early administration of the ASV has reduced morbidity and mortality. Conclusion: Gender, residence, the season of bite, the type of snakebite, pain, local oedema, extending oedema, blisters, ecchymosis, respiratory arrest, coagulopathy, CBC findings, and INR; were all excellent predictors of severity.
Comparison of snakebite cases in children and adults
There are very few studies that compare the snakebite cases in children and adults. The present study aimed to compare the demographic characteristics, clinical presentations, laboratory findings, and developed complications in pediatric and adult patients due to snakebites. PATIENTS AND METHODS: This study included the patients admitted to the hospital and monitored due to snakebite between July 1999 and December 2012. The condition of each patient who had been bitten was admitted to the hospital was monitored from the time of admission to the end of their hospital stay. The fact that a snakebite occurred was recorded if the subjects saw the snake or if the appearance of the puncture sites was convincingly a snakebite. RESULTS: The present work included 290 patients, of whom 123 were children and 167 were adults. The most common location of the bites was the lower extremity with 78.9% (n=97) and 63.5% (n=106) in pediatric and adult patients, respectively. All of the pediatric patients received prophylactic treatment with antibiotics, whereas 62 (37.1%) adult patients received antimicrobial treatments due to the soft tissue infection. The most common complication developed was pulmonary edema in children at a rate of 33.3% (n=41) and compartment syndrome in adult patients at a rate of 3% (n=5). CONCLUSIONS: Patients admitted to the hospital due to snakebite should be monitored for at least 12 hours, even if there is no sign of clinical envenomation. Antivenom treatment should be administered to the patients requiring clinical staging. Patients should be kept under close monitoring to prevent the development of serious complications such as cellulitis, pulmonary edema, compartment syndrome, and disseminated intravascular coagulation.
From “Snakebites in the new millennium: A state-of-the-art symposium”
Journal of Medical Toxicology, 2006
The venom of North American crotalines contains anticoagulants, procoagulants, fibrinolysins and hemorrhagins, as well as components that alter endothelial and platelet function. Effects include thrombocytopenia, prolonged PT and PTT, fibrinolysis, hypofibrinogenemia, and hypoprothrombinemia. Recurrence of these effects has been described after cessation of Fab antivenom treatment. This case illustrates an obscured presentation of envenomation and a common decision-making problem with recurrent hematologic effects.
2021
Although the predominant treatment for snakebite is the antivenom, other treatments are also considered. We studied the effects of single or multiple-doses of anti-inflammatory drugs on local, systemic and laboratory findings of the snakebite victims. In this cross-sectional study, 101 patients (90 male: 89.1%) with snakebite envenomation who were admitted to the Medical Toxicology Center of Khorshid Hospital, Isfahan, Iran, were investigated. One group (35 patients: 34.7%) received a single-dose of anti-inflammatory drugs containing chlorpheniramine (10mg intramuscular injection) with cimetidine (200mg intravenous injection) or ranitidine (50mg intravenous injection) plus hydrocortisone (100mg intravenous injection). The other 55 patients (54.5%) received multiple doses of the same drug combination every 8hr until the symptoms resolved. Local, systemic symptoms and laboratory findings on admission, and during 24hr and 48hr of admission, were recorded. The frequency of the localized...
A Retrospective Study on Snakebite Victims in a Tertiary Referral Center
Iranian Journal of Toxicology, 2016
Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital.