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Bothrops asper, a highly venomous pit viper distributed from Colombia and northwestern Peru in South America to southern Mexico, is responsible for most snake bites in Central America, affecting especially young agricultural workers. A 17-year-old male from a rural area in northern Honduras was admitted at San Francisco Hospital after a B. asper bite that had occurred 3 days earlier. The puncture wounds were located on the first toe of the right foot. On the second day of admission, the patient developed dyspnea. A physical examination revealed hypoventilation of the left lung with dullness on 75% of the left lung. Left pleural effusion, approximately 90%, was observed on the chest X-ray. The patient was diagnosed with hemothorax, and a thoracostomy drained 1,350 mL of serosanguineous fluid, followed by the installation of a wet suction control system (Pleur-evac®). After 10 days, the patient was discharged. This case illustrates the diversity of hemorrhagic manifestations in envenomations by B. asper.
Authors’ addresses: Luis José Pinto, Emergency Department, Hospital San Francisco, Universidad Nacional Autonoma de Honduras, Juticalpa, Honduras, E-mail: luis.pinto@unah.hn. Linda Lee Fernández, Emergency Department, Hospital San Francisco, Universidad Nacional Autonoma de Honduras, San Pedro Sula, Honduras, E-mail: linda.fernandez@unah.hn. José María Gutiérrez, Instituto Clodomiro Picado, Universidad de Costa Rica, E-mail: jose.gutierrez@ucr.ac.cr. Dany Samir Simón, Hospital San Francisco, Universidad Nacional Autonoma de Honduras, Juticalpa, Honduras, E-mail: danyssa91@gmail.com. Ziomara Ceballos, Pediatrics Department, Hospital San Francisco, Catacamas, Honduras, E-mail: ziomaraceballos@yahoo.es. Luis Fernando Aguilar, Surgery Department, Hospital San Francisco, Tegucigalpa, Honduras, E-mail: fernando95215862@gmail.com. Manuel Sierra, Epidemiology Department, Universidad Tecnológica Centroamericana, Tegucigalpa, Honduras, E-mail: manuel.sierra@unah.edu.hn.