Tonos C, Traviezo Valles LE, Pacheco C

Language: Spanish
References: 9
Page: 1-10
PDF size: 424.12 Kb.

ABSTRACT

Bothrops asper is responsible for up to 80% of ophidism in northern South America, its venom having a proteolytic and coagulant action on the affected limb. A descriptive study is carried out, with retrospective analysis, with taxonomic identification and literature review. Twelve-year-old male patient from Sanare, Lara state, Venezuela, who is hospitalized in the Intensive Care Unit for severe symptoms after a bite by Bothrops on the right leg, receives fifteen ampoules of antivenom, but the delay in the supply due to the Severe regional shortage of antivenom and receiving a high dose of the poison allowed an intense hemolytic and necrotizing action on the tissues, presenting compartment syndrome, which required fasciotomy under minimal acceptable coagulation conditions. The child had a good recovery, saving the limb from the amputation. Only 20% of cases of ophidism become serious, produced by inoculations of more than 300 mg of poison and the delay in transfer to the specialized center, this allows tissue necrosis and compartment syndrome, damage that warrants executing the fasciotomy, debridement and drainage of abscesses to avoid amputation. It is the first report of fasciotomy after Bothrops asper bite in Lara State. The immediate transfer of the patient for a specific treatment with antivenom continues to be the main measure to avoid serious cases of poisoning and thus reduce the severity of the symptoms and the lethality.

REFERENCES

1. Castrillón D, Acosta J, Hernández E, Alonso L. Envenenamiento ofídico. Salud Uninorte. 2007; 23(1): 96-111.

2. De Sousa L, Borges A, Aneda E, Bónoli S. Matos M, Parrilla P. Mortalidad causada por animales venenosos en Venezuela: 1980-1999. Saber. 2014; 26(4): 441-457.

3. Duque C, Fernández I, Vargas A, López J, Scannone H. Caracterización toxicológica del veneno de Bothrops atrox de Puerto Ayacucho, Edo. amazonas (Venezuela) y su neutralización por un antiveneno venezolano. Revista Científica. 2014; 24(4):355-362.

4. De Sousa L, Borges A, Badell M; D Onofrio M, Di Campli M, Díaz A, García F, Machado V. Morbilidad causada por contacto con animales en Venezuela (2005-2009). SABER. 2016; 28(4):1-11.

5. Alape A, Flores M, Sanz L, Madrigal M, Escolano J, Sasa M, Calvete J. Studies on the venom proteome of Bothrops asper: Perspectives and applications. Toxicon. 2009; 54: 938–948.

6. Lizarazo J, Patiño R, Lizarazo D, Osorio G. Hemorragia cerebral fatal después de una mordedura de serpiente Bothrops asper en la región del Catatumbo, Colombia. Biomédica. 2020; 40:609-15. https://doi.org/10.7705/biomedica.5181

7. Programa Nacional de Prevención y Control de las Intoxicaciones. Envenenamientos por serpientes. Buenos Aires, Argentina. 2016. Pp 9.

8. Ministerio del Ambiente. Atlas del estado Lara. 1998 [Internet]. Servicio Autónomo de Geografía y Cartografía Nacional. Barquisimeto, Venezuela. Disponible en: www.laraenred.com>atlas2017

9. Alfaro Oporta E. Síndrome Compartimental por Envenenamiento Ofídico. (Manejo de Fasciotomía con Terapia VAC). Rev Med Costa Rica y Centroamérica. 2010; 67 (594): 405-415.