Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil
From January, 1984 to March, 1999, 31 children under 15 y old (ages 1-14 y, median 8 y) were admitted after being bitten by rattlesnakes (Crotalus durissus ssp). One patient was classified as "dry-bite", 3 as mild envenoming, 9 as moderate envenoming and 18 as severe envenoming. Most patie...
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ftdoajarticles:oai:doaj.org/article:cbf4a4b0bfdd4019bf78068c3f55d352 2024-09-09T19:28:07+00:00 Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil Fábio BUCARETCHI Sílvia Regina Fontoura HERRERA Stephen HYSLOP Emílio Carlos Elias BARACAT Ronan José VIEIRA 2002-01-01T00:00:00Z https://doaj.org/article/cbf4a4b0bfdd4019bf78068c3f55d352 EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652002000300004&tlng=en https://doaj.org/toc/1678-9946 1678-9946 https://doaj.org/article/cbf4a4b0bfdd4019bf78068c3f55d352 Revista do Instituto de Medicina Tropical de São Paulo, Vol 44, Iss 3, Pp 133-138 (2002) Antivenom Children Crotalus durissus ssp Rhabdomyolysis Snakebites Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2002 ftdoajarticles 2024-08-05T17:49:31Z From January, 1984 to March, 1999, 31 children under 15 y old (ages 1-14 y, median 8 y) were admitted after being bitten by rattlesnakes (Crotalus durissus ssp). One patient was classified as "dry-bite", 3 as mild envenoming, 9 as moderate envenoming and 18 as severe envenoming. Most patients had neuromuscular manifestations, such as palpebral ptosis (27/31), myalgia (23/31) and weakness (20/31). Laboratory tests suggesting rhabdomyolysis included an increase in total blood creatine kinase (CK, 28/29) and lactate dehydrogenase (LDH, 25/25) levels and myoglobinuria (14/15). The main local signs and symptoms were slight edema (20/31) and erythema (19/31). Before antivenom (AV) administration, blood coagulation disorders were observed in 20/25 children that received AV only at our hospital (incoagulable blood in 17/25). AV early reactions were observed in 20 of these 25 cases (9/9 patients not pretreated and 11/16 patients pretreated with hydrocortisone and histamine H1 and H2 antagonists). There were no significant differences in the frequency of patients with AV early reactions between the groups that were and were not pretreated (Fisher's exact test, p = 0.12). Patients admitted less than and more than 6 h after the bite showed the same risk of developing severe envenoming (Fisher's exact test, p = 1). No children of the first group (< 6 h) showed severe complications whereas 3/6 children admitted more than 6 h post-bite developed acute renal failure. Patients bitten in the legs had a higher risk of developing severe envenoming (Fisher's exact test, p = 0.04). There was a significant association between both total CK and LDH blood enzyme levels and severity (p < 0.001 for CK and p < 0.001 for LDH; Mann-Whitney U test). No deaths were recorded. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
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topic |
Antivenom Children Crotalus durissus ssp Rhabdomyolysis Snakebites Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Antivenom Children Crotalus durissus ssp Rhabdomyolysis Snakebites Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Fábio BUCARETCHI Sílvia Regina Fontoura HERRERA Stephen HYSLOP Emílio Carlos Elias BARACAT Ronan José VIEIRA Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil |
topic_facet |
Antivenom Children Crotalus durissus ssp Rhabdomyolysis Snakebites Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
From January, 1984 to March, 1999, 31 children under 15 y old (ages 1-14 y, median 8 y) were admitted after being bitten by rattlesnakes (Crotalus durissus ssp). One patient was classified as "dry-bite", 3 as mild envenoming, 9 as moderate envenoming and 18 as severe envenoming. Most patients had neuromuscular manifestations, such as palpebral ptosis (27/31), myalgia (23/31) and weakness (20/31). Laboratory tests suggesting rhabdomyolysis included an increase in total blood creatine kinase (CK, 28/29) and lactate dehydrogenase (LDH, 25/25) levels and myoglobinuria (14/15). The main local signs and symptoms were slight edema (20/31) and erythema (19/31). Before antivenom (AV) administration, blood coagulation disorders were observed in 20/25 children that received AV only at our hospital (incoagulable blood in 17/25). AV early reactions were observed in 20 of these 25 cases (9/9 patients not pretreated and 11/16 patients pretreated with hydrocortisone and histamine H1 and H2 antagonists). There were no significant differences in the frequency of patients with AV early reactions between the groups that were and were not pretreated (Fisher's exact test, p = 0.12). Patients admitted less than and more than 6 h after the bite showed the same risk of developing severe envenoming (Fisher's exact test, p = 1). No children of the first group (< 6 h) showed severe complications whereas 3/6 children admitted more than 6 h post-bite developed acute renal failure. Patients bitten in the legs had a higher risk of developing severe envenoming (Fisher's exact test, p = 0.04). There was a significant association between both total CK and LDH blood enzyme levels and severity (p < 0.001 for CK and p < 0.001 for LDH; Mann-Whitney U test). No deaths were recorded. |
format |
Article in Journal/Newspaper |
author |
Fábio BUCARETCHI Sílvia Regina Fontoura HERRERA Stephen HYSLOP Emílio Carlos Elias BARACAT Ronan José VIEIRA |
author_facet |
Fábio BUCARETCHI Sílvia Regina Fontoura HERRERA Stephen HYSLOP Emílio Carlos Elias BARACAT Ronan José VIEIRA |
author_sort |
Fábio BUCARETCHI |
title |
Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil |
title_short |
Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil |
title_full |
Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil |
title_fullStr |
Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil |
title_full_unstemmed |
Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil |
title_sort |
snakebites by crotalus durissus ssp in children in campinas, são paulo, brazil |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2002 |
url |
https://doaj.org/article/cbf4a4b0bfdd4019bf78068c3f55d352 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 44, Iss 3, Pp 133-138 (2002) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652002000300004&tlng=en https://doaj.org/toc/1678-9946 1678-9946 https://doaj.org/article/cbf4a4b0bfdd4019bf78068c3f55d352 |
_version_ |
1809897397975777280 |