Fatal brain hemorrhage after Bothrops asper bite in the Catatumbo region of Colombia
Abstract
Snake bites are a public health problem in tropical and subtropical regions of the world.
They occur especially in rural workers and are an important source of disability and mortality.
We present the case of a 59-year-old farmer from the Catatumbo region of Colombia who was bitten by a B. asper snake and suffered a fatal brain hemorrhage after the event.
We draw attention to the severe bleeding disorder in contrast with the slight changes at the site of the bite, as well as on the importance of the early treatment of poisoning with antivenom even in the absence of significant skin manifestations.
Downloads
References
Williams DJ, Faiz MA, Abela-Ridder B, Ainsworth S, Bulfone TC, Nickerson AD, et al. Strategy for a globally coordinated response to a priority neglected tropical disease: nakebite envenoming. PLoS Negl Trop Dis 2019;13:e0007059. https://doi.org/10.1371/journal.pntd.0007059
Otero-Patiño R. Epidemiological, clinical and therapeutic aspects of Bothrops asper bites. Toxicon. 2009;54:998-1011. https://doi.org/10.1016/j.toxicon.2009.07.001
Instituto Nacional de Salud. Boletín Epidemiológico Semanal. Semana epidemiológica 52, 23 al 29 de diciembre de 2018. Fecha de consulta: 5 de julio de 2019. Disponible en: https://www.ins.gov.co/buscador-eventos/boletinepidemiologico/forms/allitems.aspx
Rojas AM. Accidente ofídico, Colombia 2017. Informe de evento, Instituto Nacional de Salud; 2018:1-16. Fecha de consulta: 8 de julio de 2019. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/ACCIDENTE%20OFÍDICO%202017.pdf
Silveira GG, Machado CR, Tuyama M, Lima MA. Intracranial bleeding following Bothrops sp. snakebite. Neurologist. 2016;21:11-2. https://doi.org/10.1097/NRL.0000000000000067
Silva-Haad JJ. Las serpientes del género Bothrops en la Amazonia colombiana. Aspectos biomédicos (epidemiología, clínica y biología del ofidismo). Acta Médica Colombiana. 1989;14:148-65.
Badillo R, Casas M, Gamarra G. Ofidiotoxicosis en el Hospital Universitario Ramón González Valencia de Bucaramanga. Acta Médica Colombiana. 1989;14:352-68.
Otero R, Tobón GS, Gómez LF, Osorio R, Valderrama R, Hoyos D, et al. Accidente ofídico en Antioquia y Chocó. Aspectos clínicos y epidemiológicos (marzo de 1989-febrero de 1990). Acta Médica Colombiana. 1992;17:229-49.
Ayerbe S. Ofidismo en el departamento del Cauca, Colombia. Epidemiología, etiología, clínica y complicaciones. Revista de la Facultad de Ciencias de la Salud de la Universidad del Cauca. 2000;2:21-7.
Otero R, Gutiérrez J, Mesa MB, Duque E, Rodríguez O, Arango JL, et al. Complications of Bothrops, Porthidium, and Bothriechis snakebites in Colombia. A clinical and epidemiological study of 39 cases attended in a university hospital. Toxicon. 2002;40:1107-14. https://doi.org/10.1016/s0041-0101(02)00104-6
Pineda D, Ghotme K, Aldeco ME, Montoya P. Accidentes ofídicos en Yopal y Leticia, Colombia, 1996-1997. Biomédica. 2002;22:14-21. https://doi.org/10.7705/biomedica.v22i1.1135
López N, Lopera C, Ramírez A. Características de los pacientes con accidente ofídico y complicaciones infecciosas atendidos en el Hospital Pablo Tobón Uribe entre los años 2000 y 2006. Acta Médica Colombiana. 2008;33:127-30.
Sevilla-Sánchez MJ, Mora-Obando D, Calderón JJ, Guerrero-Vargas JA, Ayerbe-González S. Accidente ofídico en el departamento de Nariño, Colombia: análisis retrospectivo, 2008-2017. Biomédica 2019;39:715-36. https://doi.org/10.7705/biomedica.4830
Angarita JA, Cárdenas LF. Infarto cerebral y accidente ofídico. Acta Neurológica Colombiana. 2003;19:75-9.
Cañas CA. Brainstem ischemic stroke after Bothrops atrox snakebite. Toxicon. 2016;120:124-7. https://doi.org/10.1016/j.toxicon.2016.08.005
Feitosa El, Sampaio VS, Salinas JL, Queiroz AM, da Silva IM, Gomes AA, et al. Older age and time to medical assistance are associated with severity and mortality of snakebites in the Brazilian Amazon: A case-control study. PLoS ONE. 2015;10:e0132237. https://doi.org/10.1371/journal.pone.0132237
Salinas Y. Catatumbo: análisis de las conflictividades y construcción de paz. Programa de la Naciones Unidas para el Desarrollo. 2014. p. 1-45. Fecha de consulta: 18 de julio de 2019. Disponible en: https://www.undp.org/content/dam/colombia/docs/Paz/undp-cocatatumbo-2014.pdf
Del Brutto OH, Del Brutto VJ. Neurological complications of venomous snake bites: A review. Acta Neurol Scand. 2012:125:363-72.
Angulo Y, Lomonte B. Biochemistry and toxicology of toxins purified from the venom of the snake Bothrops asper. Toxicon 2009;54:949-57. https://doi.org/10.1111/j.1600-0404.2011.01593.x
Gutiérrez JM, Escalante T, Rucavado A. Experimental pathophysiology of systemic alterations induced by Bothrops asper snake venom. Toxicon. 2009;54:976-87.
https://doi.org/10.1016/j.toxicon.2009.01.039
Oliveira SS, Alves EC, Santos AS, Pereira JP, Sarraff LK, Nascimento EF, et al. Factors associated with systemic bleeding in Bothrops envenomation in a tertiary hospital in the Brazilian Amazon. Toxins (Basel). 2019;11:22. https://doi.org/10.3390/toxins11010022
Sano-Martins IS, Fan HW, Castro SC, Tomy SC, Franca FO, Jorge MT, et al. Reliability of the simple 20 minutes whole blood clotting test (WBCT20) as an indicator of low plasma fibrinogen concentration in patients envenomed by Bothrops snakes. Butantan Institute Antivenom Study Group. Toxicon. 1994;32:1045-50. https://doi.org/10.1016/0041-0101(94)90388-3
Benjamin JM, Chippaux JP, Sambo BT, Massougbodji A. Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation. J Venom Anim Toxins Incl Trop Dis. 2018;24:14. https://doi.org/10.1186/s40409-018-0151-1
Mosquera A, Idrovo LA, Tafur A, Del Brutto OH. Stroke following Bothrops spp. snakebite. Neurology. 2003;60:1577-80. https://doi.org/10.1212/01.wnl.0000061614.52580.a1
Mise YF, Lira-da-Silva RM, Carvalho FM. Time to treatment and severity of snake envenoming in Brazil. Rev Panam Salud Pública. 2018;42:e52. https://doi.org/10.26633/RPSP.2018.52
Gutiérrez JM, Chaves F, Bolaños R. Estudio comparativo de venenos de ejemplares recién nacidos y adultos de Bothrops asper. Rev Biol Trop. 1980;28:341-51.
Alape-Girón A, Sanz L, Escolano J, Flores-Díaz M, Madrigal M, Sasa M, et al. Snake venomics of the lancehead pitviper Bothrops asper: Geographic, individual, and ontogenetic variations. J Proteome Res. 2008;7:3556-71. https://doi.org/10.1021/pr800332p
Otero-Patiño R. Snake bites in Colombia. In: Gopalakrishnakone P, Faiz S, Gnanathasan C, Habib A, Fernando R, Yang CC, editors. Clinical Toxinology. S Dordrecht: Springer; 2014. p. 1-42. https://doi.org/10.1007/978-94-007-6288-6_41-2
Some similar items:
- María José Sevilla-Sánchez, Santiago Ayerbe-González, Eliana Bolaños-Bolaños, Snakebite biomedical and epidemiological aspects in the department of Cauca, Colombia, 2009-2018 , Biomedica: Vol. 41 No. 2 (2021)
- María José Sevilla-Sánchez, Diana Mora-Obando, Jhon Jairo Calderón , Jimmy Alexander Guerrero-Vargas, Santiago Ayerbe-González , Snakebite in the department of Nariño, Colombia: a retrospective analysis, 2008-2017 , Biomedica: Vol. 39 No. 4 (2019)
- Santiago Ayerbe-González , Gloria Esperanza Condiza-Benavides , María José Sevilla-Sánchez, First record of snakebites by Micrurus ortoni and Micrurus hemprichii (Serpentes: Elapidae) in Colombia and Perú , Biomedica: Vol. 41 No. 4 (2021)
- Oswaldo Nina-Cueva , Derly Olazabal-Chambilla , Jair Quispe-Arpasi , Adell Alzamora-Sánchez, Mauricio Gomes-Heleno , Salomón Huancahuire-Vega, Biochemical characterization of Bothrops roedingeri Mertens, 1942 snake venom and its edematogenic, hemorrhagic, and myotoxic activities , Biomedica: Vol. 40 No. 4 (2020)
- Viviana Alexandra Martínez-Villota , Paulo Francisco Mera-Martínez, José Darío Portillo-Miño, Massive acute ischemic stroke after Bothrops spp. envenomation in southwestern Colombia: Case report and literature review , Biomedica: Vol. 42 No. 1 (2022)
- Teddy Angarita-Sierra, Alejandro Montañez-Méndez , Tatiana Toro-Sánchez , Ariadna Rodríguez-Vargas , A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia , Biomedica: Vol. 40 No. 1 (2020)
- Raúl Murillo, Ricardo Cendales, Carolina Wiesner, Marion Piñeros, Sandra Tovar, Effectiveness of cytology-based cervical cancer screening in the Colombian health system , Biomedica: Vol. 29 No. 3 (2009)
- Jaime E. Bernal, Martha Lucía Tamayo , Ignacio Briceño , Escilda Benavides , Newborn screening in Colombia: The experience of a private program in Bogotá , Biomedica: Vol. 44 No. 1 (2024)
- Andrés Páez, Gloria Rey, Carlos Agudelo, Alvaro Dulce, Edgar Parra, Hernando Díaz-Granados, Damaris Heredia, Luis Polo, Outbreak of urban rabies transmitted by dogs in Santa Marta, northern Colombia , Biomedica: Vol. 29 No. 3 (2009)
- Patricia Escobar, Katherine Paola Luna, Indira Paola Hernández, César Mauricio Rueda, María Magdalena Zorro, Simon L. Croft, In vitro susceptibility of Trypanosoma cruzi strains from Santander, Colombia, to hexadecylphosphocholine (miltefosine), nifurtimox and benznidazole , Biomedica: Vol. 29 No. 3 (2009)
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
