Snake Bites and Significance of Antivenom Treatment

Year 2021, Volume: 12 Issue: 42, 51 - 53, 15.04.2021

Ali Karakuş Ezgi Atalay

https://doi.org/10.17944/mkutfd.809773

Abstract

Snake venoms contains complex enzymes and toxic proteins. Snake bites have a wide clinical spectrum from dry bites to death. The main treatment is antivenom application. 13-year-old female patient was brought to emergency service with a snake bite complaint. General medical condition was not good. Patient was agitated and confused, but able to answer question. Her Glasgow coma scale (GCS) was 10. On admission his vital signs were temperature 36,3°C, blood pressure 90/40 mmHg, pulse rate 120/min, and pulse oximetry reading of 94%. Outer malleolus of the right foot has slight edema, hematoma, ecchymotic areas in extremities, and hemorrhage in the mouth. Prolong of Pancytopenia and International Normalized Ratio (INR) were detected abnormally in blood samples. The snake antivenom was given 4x2 dose and total 14 ampoules to the patient. After 3 days of follow-up, the patient was discharged with healing. Antivenom treatment should be given at the appropriate time, in a sufficient dose and in the appropriate patient. Thus, possible deaths can be prevented.

Keywords

Sneke bites, antivenom treatment, morbidity

Yılan Isırmaları ve Antivenom Tedavisinin Önemi

Abstract

Yılan venomları kompleks enzim ve toksik proteinler içerir. Hastaların kliniği kuru ısırıktan ölüme kadar çok geniş yelpazede olabilir. Tedavide asıl olan antivenom uygulamasıdır. 13 yaşında bayan hasta acil servise 1 saat önce yılan ısırması nedeniyle getirildi. Genel durumu kötü, şuuru konfüze, ajite ve Glaskow Koma Skalası 10 idi. Tansiyon arteryel 90/40mmHg, nabız 120/dk idi. Sağ ayak dış malleolde hafif ödem, hematom, ekstremitelerde ekimotik alanlar ve ağız içinde kanaması mevcuttu. Kan tahlillerinde anormal olarak pansitopeni ve International Normalized Ratio (INR) uzaması tespit edildi. Hastaya 4x2 doz, toplam 14 ampul yılan antivenomu verildi. 3 gün boyunca takip edilen hasta şifayla taburcu edildi. Antivenom tedavisi zamanında, yeterli dozda ve uygun hastaya verilmelidir. Bu sayede oluşabilecek morbiditeler önlenebilir.

Keywords

yılan ısırması, antivenom tedavi, morbidite

References

• Karakuş A, Duru M, Kuvandık G, Kaya E, Kekeç Z. Snake Bites in Winter Season: A Case Report. Istanbul Med J. 2013;14(1):47-48. https://doi.org/10.5152/imj.2013.11
• Karakuş A, Zeren C, Celik MM, Ozden R , Arıca S, Duru M , Tasin V . A 5-year retrospective evaluation of snakebite cases in Hatay, Turkey. Toxicology and Industrial Health. 2015; 31(2): 188-192. https://doi.org/10.1177/0748233712472522
• Karakuş A,Ozkan M,Karcioglu M, Ozden R,Ustun I,Calıskan K, Gokce C, Sahan M. Diabetic Foot Due to Anaphylactic Shock: A Case Report. Arch Trauma Res. 2014 ; 3(2):1-3. https://doi.org/10.5812/atr.17610
• Karakuş A. Attention to compartment syndrome in snakebites! İzmir Dr. Behçet Uz Çocuk Hast. Dergisi. 2015; 5(3):217-218. https://doi.org/10.5222/buchd.2015.217
• Karakus A, Kuvandık G. Yılan ısırması sonrası hematüri gelişen olgu. Firat Med J. 2016; 21(4): 229-230.
• Adukauskiene D, Varanauskiene E, Adukauskaite A. Venomous snakebites. Medicina (Kaunas). 2011;47(1), 461-467. https://doi.org/10.3390/medicina47080061
• Bulut M, Eren Ş, Özdemir F, Köksal O, DurmuŞ O, Esen M, et al. Snakebite cases admitted to Uludağ University Faculty of Medicine Emergency Department and current management of snake bite. Akademik Acil Tıp Dergisi 2009;8:31-4. https://doi.org/10.4170/jaem.2009.01.0006
• Satar S, Karcıoglu O, Sebe A. An usual localization of snakebite antivenin treated without: a case report. The Mount Sinai Journal of Medicine 2005;72(1):116-9.
• Şahan M, Duru M, Çalışkan K, Karakuş A, Özcan O, Kahraman A, Kuvandık G. Snake Envenomation to the Face of A Child-Rare Case. Prague Medical Report. 2015;116(4): 314-320. https://doi.org/10.14712/23362936.2015.70
• Şahan M, Taşın V, Karakuş A, Özcan O, Eryiğit U, Kuvandık G. Evaluation of patients with snakebite who presented to the emergency department: 132 cases. Turkish Journal of Trauma & Emergency Surgery. 2016;22(4):333-337.