Viperidae snake envenomation from a highly complex hospital in southwestern Colombia

• Published in: Heliyon 2024-03, Vol.10 (5), p.e26768-e26768, Article e26768
• Main Authors: Erazo-Martínez, Valeria, Posso-Osorio, Iván, Ruiz-Ordoñez, Ingrid, Castro-Herrera, Fernando, Castaño-Valencia, Santiago, Delgado-Mora, Tatiana, Cañas, Carlos A.
• Format: Article
• Language: English
• Subjects: Bothrops; Coagulopathy; Polyvalent antivenom; Snakebites; Viper
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e26768

Snake envenomation is a medical condition with high morbidity and mortality in southwestern Colombia. To describe the characteristics of the envenomation caused by Viperidae snakes view in a highly complex hospital in Southwestern Colombia. A cross-sectional study was carried out. Patients treated for Viperidae snake envenomation from 2001 to 2020 in a Hospital Fundación Valle del Lili, Cali, Colombia, were studied. Twenty-eight patients were included. Envenomation was caused by the genera Bothrops, Bothriechis, Porthidium, and Bothrocophias. The median age was 37.7 (±20.6), and they were predominantly male (19, 68%). Bites occurred on the upper extremities in 16 (57%) patients. Pain (23, 81%) and edema (22, 78%) were the most common clinical symptoms. Thirteen (46%) patients presented coagulopathy. Prolonged prothrombin and activated partial thromboplastin times were common: (22, 78% and 15, 53%, respectively). Twenty (71%) patients were treated with polyvalent antivenom (median dose of 6 (2–15) vials). The median time between the accident and antivenom administration was 9 h (5.5–17). Door-to-needle time was 37.5 (0–62) min. Eighteen (64%) patients were admitted to the intensive care unit. Three (11%) patients had serum sickness. Seven (25%) developed infectious complications, four (14%) had surgery, one (3%) had compartment syndrome, one (3%) underwent amputation of the affected limb, and one (3%) patient died. Local manifestations and coagulopathy were common clinical features. Polyvalent antivenom was an effective treatment for disease control. Significant complications were associated with delays in seeking medical care.