1921
Volume 99, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

is an endemic species in Martinique, where approximately 30 cases of envenoming are managed yearly. Envenoming characteristics from species include local tissue damage, systemic bleeding, and hemodynamic alterations. We hereby report a case of severe envenomation following snakebite to the right calf. Severe local manifestations developed progressively up to the lower limb despite adequate antivenom therapy. Systemic manifestations of venom also occurred, resulting in intensive care therapy. Surgery exploration revealed soft tissue necrosis, friability of the deep fascia, and myonecrosis. The patient needed multiple debridement procedures and fasciotomy of all leg compartments and anterior compartment of the thigh. Diagnosis of necrotizing fasciitis was confirmed by positive blood cultures. This clinical case illustrates that major soft tissue infection, including necrotizing fasciitis may occur after snakebite. Abnormal coagulation tests should not delay surgical management, as severe envenoming is a life-threatening condition.

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References

  1. Resiere D, Mégarbane B, Valentino R, Mehdaoui H, Thomas L, , 2010. Bothrops lanceolatus bites: guidelines for severity assessment and emergent management. Toxins (Basel) 2: 163173. [Google Scholar]
  2. Delafontaine M, Villas-Boas IM, Mathieu L, Josset P, Blomet J, Tambourgi DV, , 2017. Enzymatic and pro-inflammatory activities of Bothrops lanceolatus venom: relevance for envenomation. Toxins (Basel) 9: 244. [Google Scholar]
  3. Thomas L, Tyburn B, Bucher B, Pecout F, Ketterle J, Rieux D, Smadja D, Garnier D, Plumelle Y, , 1995. Prevention of thromboses in human patients with Bothrops lanceolatus envenoming in Martinique: failure of anticoagulants and efficacy of a monospecific antivenom. Research Group on Snake Bites in Martinique. Am J Trop Med Hyg 52: 419426. [Google Scholar]
  4. Lôbo de Araújo A, Kamiguti A, Bon C, , 2001. Coagulant and anticoagulant activities of Bothrops lanceolatus (fer de lance) venom. Toxicon 39: 371375. [Google Scholar]
  5. Lôbo de Araújo A, Donato JL, Bon C, , 1998. Purification from Bothrops lanceolatus (fer de lance) venom of a fibrino (geno) lytic enzyme with esterolytic activity. Toxicon 36: 745758. [Google Scholar]
  6. Gutiérrez JM, Sanz L, Escolano J, Fernández J, Lomonte B, Angulo Y, Rucavado A, Warrell DA, Calvete JJ, , 2008. Snake venomics of the lesser antillean pit vipers Bothrops caribbaeus and Bothrops lanceolatus: correlation with toxicological activities and immunoreactivity of a heterologous antivenom. J Proteome Res 7: 43964408. [Google Scholar]
  7. Terra RM, Pinto AF, Guimarães JA, Fox JW, , 2009. Proteomic profiling of snake venom metalloproteinases (SVMPs): insights into venom induced pathology. Toxicon 54: 836844. [Google Scholar]
  8. Cardoso KC, Da Silva MJ, Costa GGL, Torres TT, Del Bem LEV, Vidal RO, Menossi M, Hyslop S, , 2010. A transcriptomic analysis of gene expression in the venom gland of the snake Bothrops alternatus (urutu). BMC Genomics 11: 605. [Google Scholar]
  9. Barbosa-Souza V, Contin DK, Filho WB, de Araújo AL, Irazusta SP, da Cruz-Höfling MA, , 2011. Osteopontin, a chemotactic protein with cytokine-like properties, is up-regulated in muscle injury caused by Bothrops lanceolatus (fer-de-lance) snake venom. Toxicon 58: 398409. [Google Scholar]
  10. Tsai YH, Hsu WH, Huang KC, Yu PA, Chen CL, Kuo LT, , 2017. Necrotizing fasciitis following venomous snakebites in a tertiary hospital of southwest Taiwan. Int J Infect Dis 63: 3036. [Google Scholar]
  11. Guimarães AQ, Cruz-Höfling MA, Ferreira de Araújo PM, Bon C, Lôbo de Araújo A, , 2004. Pharmacological and histopathological characterization of Bothrops lanceolatus (fer de lance) venom-induced edema. Inflamm Res 53: 284291. [Google Scholar]
  12. Jorge MT, Ribeiro LA, O’Connell JL, , 1999. Prognostic factors for amputation in the case of envenoming by snakes of the Bothrops genus (Viperidae). Ann Trop Med Parasitol 93: 401408. [Google Scholar]
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  • Received : 08 May 2018
  • Accepted : 27 Aug 2018
  • Published online : 17 Sep 2018

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