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At least 19 recordsLinked to original sources
PubMedDate not supplied

Non-venomous snake bite and snake bite without envenoming in a Brazilian teaching hospital. Analysis of 91 cases.

A retrospective survey of 473 cases of snake bite admitted to a Brazilian teaching hospital from 1984 to 1990 revealed 91 cases of bite without envenoming and/or caused by non-venomous snakes. In 17 of these cases the snake was identified, and one patient was bitten by a snake-like reptile (Amphisbaena mertensii). In 43 cases diagnosis was made on clinical grounds (fang marks in the absence of signs of envenoming). The other 30 cases were of patients who complained of being bitten but who did not show any sign of envenoming or fang mark. Most cases occurred in men (66;73%), in the 10-19 years age group (26;29%), in the lower limbs (51/74;69%), between 6 A. M. and 2 P.M. (49;61%) and in the month of April (16;18%). One patient bitten by Philodryas olfersii developed severe local pain, swelling and redness at the site of the bite, with normal clotting time. The patient bitten by Drymarcon corais was misdiagnosed as being bitten by a snake of the genus Bothrops, was given the specific antivenom, and developed anaphylaxis. One patient bitten by Sibynomorphus mikanii presented prolonged clotting time, and was also given antivenom as a case of Bothrops bite. Correct identification of venomous snakes by physicians is necessary to provide correct treatment to victims of snake bite, avoiding unnecessary distress to the patient, and overprescription of antivenom, which may eventually cause severe untoward effects.

Adolescent↗
PubMed1995

[Snake bites].

Snake bites are a rare occurrence in Belgium. Nevertheless, all doctors should know how to react to this potentially very dangerous emergency. A snakebite does not necessarily result in poisoning: the effects can range from a little local discomfort to a severe systemic reaction with multiple organ failure. Therefore, all snake bites must be treated as serious and should receive adequate treatment. At the same time, hysterical over reaction must be avoided for this risks complications. This article reviews the principal elements of snake bite treatment: from the emergency stage through to stabilization in the hospital. Key points raised are the necessity to immobilize the affected region, to establish adequate perfusion and to anticipate infectious complications. Serum therapy indications are reviewed together with adjuvant interventions such as corticotherapy and heparin therapy.

Adrenal Cortex Hormones↗
PubMed1981

Acute renal failure in children following snake bite.

Snake venom poisoning accounted for 1.4% of 4360 infants and children admitted to a south Indian hospital during the years 1976-1979 and was the commonest cause of acute renal failure encountered. Most of the 42 children with anuria following snake bite had evidence of intravascular coagulation and acute tubular necrosis. Russell's viper was the only snake recognized in all the cases of anuria in which species identification was possible. Renal failure complicating snake bite was relatively more frequent and more severe in children than in adults.

Acute Kidney Injury↗
PubMed1980

[Glomerulonephritis following snake bite].

A snake bite may quite frequently lead to haemorrhagic symptoms ranging from hypofibrinogenaemia to disseminated intravascular coagulation. In rare cases acute renal insufficiency associated with tubular necrosis may occur due to a direct toxic lesion, shock symptoms or DIC. However, it is extremely rare that glomerulonephritis results from a snake bite. A thirteen-year-old girl develops gross haematuria, albuminuria and cylindruria without any shock symptoms two days after having been bitten by a European viper. Coagulation state and complement show slight changes, and the histological examination reveals proliferative nephritis with deposition of immune complexes. The clinical picture corresponds to recurrent haematuria; renal function is normal after follow-ups over a one-year-period.

Adolescent↗
PubMed2000

[Viper (Vipera berus) snake bites].

Cases of snake bites (Vipera berus) have as compared with past years a rising trend in the Czech Republic. This ensues among other factors from a higher prevalence of snakes due to the improving ecological situation. The morbidity of snake bites is of no epidemiological importance, the frequency of snake bites amounts to several tens per year and in some clinically manifest intoxication does not develop. Nevertheless in individual cases, in children weakened subjects, a viper bite may be manifested by a serious and in exceptional instances fatal affection. Within the framework of first aid the authors do not recommend application of a tourniquet or dissecting of the wound because of undesirable potentiation of tissue traumatization. Non-specific treatment involves the administration of corticoids and antihistaminics. Specific immunotherapy, administration of horse antiserum (Ipser Europe, Pasteur Mérieux, France) is indicated only in case of systemic or very severe local symptoms and is associated with the risk of a severe allergic reaction. In case of severe systemic symptoms, symptomatic treatment in a health institution of the appropriate type is of fundamental importance. In all cases observation of the affected subject is recommended to rule out intoxication or the development of possible complications.

Adult↗
PubMed1994

[Snake bite by a poisonous snake. Report of an unusual case].

We report on a 31-year-old white woman, who was bitten in her right calf by a "spitting cobra" (Neia nigricollis) during a safari in Tansania. Minor initial systemic symptoms such as nausea and vomiting were followed by severe oedematous swelling of the extremity after 2-3 h and demarcation of a 2.75 x 2.75 in. area of necrotic skin. The patient returned to her home country, where 8 days after the snake-bite necrosectomy was performed. Antibiotics, anti-inflammatory agents and local therapy with hydrocolloidal wound dressings were administered. With this therapy the lesion healed completely with minor scarring within 5 months. A new Salmonella strain was isolated from the ground of the ulcer.

Adult↗
PubMed1980

Incidence and mortality on snake bite in savanna Nigeria.

Snake bite is a major medical problem among farming communities in the Benue and Niger Valley savanna region of Nigeria. Surveys in the more densely populated northern savanna areas such as Malumfashi (incidence 48 per 100 000 population, mortality 5.1%) show that the spitting cobra, Naja nigricollis, was the predominant species of medical importance. In the less cultivated Benue Valley area the annual snake-bite incidence was estimated to be 497 per 100 000 population, with a 12.2% mortality due mainly to the carpet viper, Echis carinatus. From these findings we estimate a yearly total of almost 10 000 deaths from snake bite in savanna Nigeria and about 23 000 deaths in West Africa. To rectify this serious health problem, concerted efforts are urgently needed.

Health Services↗
PubMed1986

Prediction, prevention, and mechanism of early (anaphylactic) antivenom reactions in victims of snake bites.

Victims of snake bites are often subjected to cutaneous or conjunctival hypersensitivity testing before being given antivenom. None of 12 early (anaphylactic) reactions was predicted by these tests in 25 Nigerian and Thai patients. The incidence and severity of early reactions was the same whether antivenom was given by intravenous injection over 10 minutes or diluted and given as an intravenous infusion over 30 minutes. Although antivenom activated complement in vitro, there was no evidence of complement activation or formation of immune complexes in patients bitten by snakes who were treated with antivenom, whether or not they developed early reactions. Higher doses of antivenom might induce the complement activation and formation of immune complexes (aggregates) that have been observed during the clinically more severe reactions associated with homologous immunoglobulin treatment.

Anaphylaxis↗
PubMed1998

Snake bite in the Thar Desert.

Snake bite remains a common injury in endemic areas of Pakistan. A facility based observational study was undertaken to ascertain the incidence of snake bite, its mortality and the management in public health facilities located in the Thar Desert of Province of Sindh, Pakistan. A total of 771 cases of snake bite were reported to seven randomly selected health facilities during a one-year period. Most (75%) occurred during nighttime in summer, affecting primarily males (70%) who were bitten mostly on the lower extremities (83%). Five hundred and thirteen bites (66%) were identified as poisonous and 4 deaths were reported. Seventy two percent of patients reached the health facility within 24 hours and twenty percent within 6 hours and of being bitten. Snake bite remains an important problem in endemic areas of Pakistan. People do seek assistance at public health facilities, where appropriate treatment including anti snake venom is given.

Adolescent↗
PubMedDate not supplied

Snake bites in the hills of north India.

BACKGROUND: Snake bites are a common cause of morbidity and mortality in the hills. The risk of snake bite is high due to the presence of a huge herpeto fauna flourishing in a favourable climate--low environmental temperature and heavy rainfall. In India, there are 236 species of snakes of which four are dangerously venomous. This study was undertaken to determine the risk factors exposing the population to snake bite and the common types of snakes causing them. METHODS: We studied 243 patients of snake bite over a period of 24 months. All patients were examined for evidence of snake bite and, where possible, the snakes were identified based on description, identification (if the snake was brought) and symptoms of envenomation. RESULTS: Seasonal variation in snake bite was seen, with a peak in the months of August and September. No bites were recorded in December, January and February. Eighty-four per cent of the bites were on the hands and feet (up to the ankle). Bites on the hand were more common in females with a left hand preponderance (3.5 times higher). The age group most affected was between 11 and 40 years (73.7%). Most bites occurred while the person was cutting grass, working in the fields or walking in the hills (75.3%). Snake bites while sleeping were at uncommon sites. Non-poisonous snakes were the most common (90.5%). Kraits caused 60% of bites with envenomation. CONCLUSION: Snake bites occur frequently in the hills of Himachal Pradesh. Although snake bites are a cause for concern, most of them are caused by non-poisonous snakes.

Adolescent↗
PubMed1999

Randomized controlled trial on the effective dose of anti-snake venom in cases of snake bite with systemic envenomation.

Snake bite is the common cause of morbidity and mortality in India. Snake antivenom, although very effective, is expensive, scarce, and associated with side effects. The conventional dose may not be required in all cases and a smaller dose may be as effective. A randomized double blind controlled trial was conducted to compare the effect of lower versus the conventional (high) dose. Patients presenting within 24 hours of snake bite with hematological or neurological evidence of systemic envenomation were included in the study. Patients were randomized either to receive high dose (2 vials over 1 hour, followed by 2 vials over 4 hours and repeated 4 hourly until clotting parameters normalized and then 2 vials as infusion over 24 hours) or low dose (2 vials over 1 hour, followed by 1 vial over four hours, repeated 4 hourly until clotting parameters were normalized and then 1 vial as an infusion over 24 hours). Thirty one patients received high dose and 29 a low dose. The mean dose of antivenom used was significantly different in the two groups (8.9 and 4.7, respectively). There was no mortality. The duration of stay was 4.94 and 3.48 days, respectively. There was no difference in the transfusion, dialysis or ventilation requirement of the two groups. Low dose regimen is more effective and required 5 vials less than the conventional dose. Each vial costs Rs. 200, so the estimated savings is Rs. 1000 per patient.

Adult↗
PubMed1996

Snake bite--an occupational hazard?

Snake bite envenomation demands a high level of knowledge and skill on the part of the critical care nurse. The following paper examines a case study of one patient who presented on two separate occasions, with snake bites from a taipan and then, 6 months later, from a death adder. Snake venom contains a variety of complex substances which do vary between the snake species; therefore, the different forms of envenomation require different modalities of treatment. This paper seeks to examine the different management required for each specific episode of envenomation. It compares the characteristics of the two snakes and examines the different effects of envenomation in both cases.

Accidents, Occupational↗
PubMed1998

A clinico-epidemiological study of snake bite in Nepal.

Envenoming from snake bite is an important medical condition, frequently encountered at the emergency department of BPKIHS hospital (Dharan, Nepal). This is a retrospective study of 52 cases of suspected snake bite who presented at the department from August 1993 to November 1994. Analysis of the data showed that snake bite was more frequent between the ages of 11 to 20 years (36.7%) and 2.5 times more common in males. Fifty-seven per cent of the bites occurred between 1600 h and midnight with highest incidence (51%) occurring during the monsoon (August-October). Twenty per cent of the patients were able to identify the snake species as venomous and 90% of them presented to the hospital within 3 h of being bitten. Sixty per cent of the bites were in the lower limb. Neurotoxicity due to envenoming was recorded in nine patients (17%). No case of coagulopathy was recorded. The overall case fatality was 3.8% but mortality amongst those exhibiting signs of neurotoxicity was 22%.

Adolescent↗
PubMed1992

Epidemiology of snake bite in the district of Burdwan, West Bengal.

An epidemiological field survey on snake bite was conducted on 26 randomly selected villages with a population of 18,892 in the district of Burdwan, West Bengal to assess the magnitude of the problem in a decade (1980-1989). Total number of snake bite, number of presumably poisonous snake bite and deaths due to snake bite poisoning were 307, 48 and 31 respectively. The death rate among snake bite victims was 10.09%. Males (54.72%) were bitten more than females (45.23%) and highest incidence of snake bite was found in the age group of 21-30 years and during the months of July and August. Majority of the snake bites (53%) were encountered in the lower extremities. Among the snake bite patients 201 (65.47% went to the traditional healers (ozhas) and 68 (22.14%) persons received hospital treatment, while 12 (3.09%) people neither went to the ozhas nor to hospital and 26 (8.46%) persons went to hospital after consulting the ozhas. If the present data are extrapolated for the total population of the district, average number of snake bite and death per year would be 7,857 (0.16%) and 793 (0.016%) respectively. Deaths due to snake bite per 100,000 population varied from 5.28 to 31.75 (average 16.4) over 10 years.

Adolescent↗
PubMed1998

Venomous snake bite of a child.

Venomous snake bites account for 9 to 15 deaths yearly. This is a low number considering that approximately 8,000 venomous snake bites occur each year. These deaths may be prevented by proper and timely medical treatment.

Child, Preschool↗
PubMed1974

Immunodiagnosis of snake bite.

Management of a patient with snake bite is influenced by the nature of the offending snake. Species diagnosis based on the patient's history and physical signs is often unreliable and the possibility of making a species diagnosis by immunological means has therefore been investigated. Wound aspirates, blister fluids, sera, and urine samples from patients with snake bite were examined for the presence of species-specific venoms using immunodiffusion. A positive species diagnosis was made in 40 out of 101 patients. Immunodiagnosis was especially successful in patients bitten by the puff adder, Bitis arietans, and the African spitting cobra, Naja nigricollis. A higher success rate could probably be achieved using more specific antisera and more sensitive assay techniques.

Animals↗