ORIGINAL ARTICLE   

Minerva Pediatrica 2017 April;69(2):121-8

DOI: 10.23736/S0026-4946.16.04226-2

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

A retrospective review of rattlesnake bites in 100 children

Norberto SOTELO-CRUZ ¹, Norberto GÓMEZ-RIVERA ² ✉

¹ Department of Medicine and Health Sciences, University of Sonora, Children’s Hospital of the State of Sonora (HIES), Hermosillo, Sonora, Mexico; ² Emergency Service, Children’s’ Hospital of the State of Sonora (HIES), Hermosillo, Sonora, Mexico

BACKGROUND: A retrospective review of clinical features and treatment of children hospitalized for rattlesnake bite.
METHODS: One hundred clinical records were reviewed. Variables included: age, gender, season of the year, signs, symptoms, poisoning grade, complications, treatment and sequelae.
RESULTS: Fifty-nine percent were males and 37% were less than 5 years of age; 87% occurred in rural areas; 63% of the snakebites occurred during the summer, of them, 39% occurred within the perimeter of the domicile and 8% within the home. Sixty-seven percent of children bitten by snakes reached the second degree of envenomation. During the first period (1977-1996), treatment for intoxication included treatment with polyvalent equine anti-snake venom serum. During the second period (1997-2014, a polyvalent polyclonal horse anti-snake venom F(Ab) was used. The second period hospitalization time was reduced to 3.9 days (P<0.0001). Hematological complications dominated during the first period (P=0.093) with wound infections occurring in 26% of the cases, neurological symptoms in 24 %, fasciotomy in 6% and mortality in 1%. The second degree poisoning was more frequent and was more severe in 7% of the patients. It was determined that the best treatment for snakebite was F(Ab’) 2 therapy. Mortality occurred in 1% of the cases.
CONCLUSIONS: Rattlesnake (Crotalus sp.) bite, in Mexico is less frequent as compared to other crotalidae species. The hematological complications are more frequent. We did not observe any recurrent phenomenons.

KEY WORDS: Crotalus - Snake bites, complications - Child