A Study of Complications of Poisonous Snake Bites

Abstract

BACKGROUND The present study was taken up to study the clinical manifestations, complications, and outcome in patients with poisonous snake bites admitted to Vivekanand Hospital, Latur (Maharashtra). METHODS This was a longitudinal study. Adult snakebite patients admitted from December 2012 to November 2014 were studied. RESULTS Mostly males (71.4 %) in the age group 18 - 29 years (58.6 %) were affected. Farmers (71.4 %) in rural areas (87.1 %) are the major sufferers. The neurotoxic venom poisoning ptosis (100 %) was commonest manifestation and was found in all cases. Palatal and pharyngeal palsy, ophthalmoplegia, respiratory palsy were also seen. In hemotoxic poisoning, bleeding from the bite site (73 %) was the commonest manifestation followed by hematuria (48.6 %) and gum bleeding (24.3 %). Among complications of poisonous snakebites, cellulitis (86.5 %) was the most common followed by acute renal failure (47.6 %), disseminated intravascular coagulation (DIC) (23.8 %), respiratory paralysis (12.7 %) and shock (4.28 %). Adverse reactions to anti-snake venom (ASV) were noted in 16 (22.9 %) patients. Total 10 patients died (14.3 %) mostly were due to acute renal failure (26.6 %). CONCLUSIONS Snakebite is common among agricultural labourers. Mostly males in the age group 18 - 29 years were bitten during 12 noon to 6 pm. Peak incidence peaked in between May to October. Viper bites were more common than Elapidae in this study. In neurotoxic envenomation, ptosis was the commonest and earliest symptom while in hemotoxic envenomation, most common symptoms were bleeding from bite site and hematuria. The commonest complications were cellulitis, acute renal failure and DIC. Early hospitalization and timely ASV were the corner stone in the treatment of snakebite. KEY WORDS Snakebite, Neurotoxic, Elapidae, Viperidae