Fatal stroke after Bothrops snakebite in the Amazonas state, Brazil: A case report

Bothrops atrox is the snake responsible for the majority of snakebites in the Brazilian Amazon. Patients generally evolve to local manifestations such as edema, pain and ecchymoses. Systemic effects of B. atrox venom are usually restricted to blood incoagulability and spontaneous bleeding. However,...

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Bibliographic Details
Published in:Toxicon (Oxford) 2017-11, Vol.138, p.102-106
Main Authors: Silva de Oliveira, Sâmella, Freitas-de-Sousa, Luciana Aparecida, Alves, Eliane Campos, de Lima Ferreira, Luiz Carlos, da Silva, Iran Mendonça, de Lacerda, Marcus Vinícius Guimarães, Fan, Hui Wen, Moura-da-Silva, Ana Maria, Monteiro, Wuelton Marcelo
Format: Article
Language:English
Subjects:
Animals
Antivenins - administration & dosage
Antivenins - therapeutic use
Blood Coagulation Disorders - chemically induced
Bothrops
Bothrops envenoming
Brain Chemistry
Brazil
Coagulopathy
Crotalid Venoms - analysis
Crotalid Venoms - toxicity
Fatal Outcome
Female
Hemorrhage
Humans
Intracranial Hemorrhages - complications
Middle Aged
Snake Bites - complications
Stroke
Stroke - complications
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Summary:Bothrops atrox is the snake responsible for the majority of snakebites in the Brazilian Amazon. Patients generally evolve to local manifestations such as edema, pain and ecchymoses. Systemic effects of B. atrox venom are usually restricted to blood incoagulability and spontaneous bleeding. However, in a few cases, bleeding in the central nervous system may occur, which can lead to sequels and deaths. Here, we report a case of a 59 year-old woman who presented edema, pain and ecchymoses on the right foot, headache, nausea, diarrhea, hypertension and blood incoagulability after the bite by Bothrops snake in the Brazilian Amazon. This case evolved with stroke resulting in death despite the antivenom and conservative therapy employed. In addition, we were able to identify the presence of venom in the patient's brain tissue after death. Direct action of toxins present in the snake's venom in the induction of systemic hemorrhage allied to blood incoagulability and hypertension presented by the patient could be involved in the mechanism of stroke in this case. •We report a case of stroke after Bothrops snakebite in the Brazilian Amazon.•The case evolved with death despite the antivenom and conservative therapy employed.•Venom was found in the patient's brain tissue after death by immunohistochemistry.
ISSN:0041-0101
1879-3150
DOI:10.1016/j.toxicon.2017.08.021