• 1.

    Chaves LF, Chuang GW, Sasa M, Gutiérrez JM, 2015. Snakebites are associated with poverty, weather fluctuations, and El Niño. Sci Adv 1: e1500249.

    • Search Google Scholar
    • Export Citation
  • 2.

    Otero-Patiño R, 2009. Epidemiological, clinical and therapeutic aspects of Bothrops asper bites. Toxicon 54: 9981011.

  • 3.

    Sasa M, Wasko DK, Lamar WW, 2009. Natural history of the terciopelo Bothrops asper (Serpentes: Viperidae) in Costa Rica. Toxicon 54: 904922.

  • 4.

    Solórzano JO, Aguilar NC, Banegas E, 2016. Mordedura de Serpiente. Boletín Epidemiológico Años 2014–2015. Tegucigalpa, Honduras: Secretaria de Salud.

    • Search Google Scholar
    • Export Citation
  • 5.

    Gutiérrez JM, 2014. Current challenges for confronting the public health problem of snakebite envenoming in Central America. J Venom Anim Toxins Incl Trop Dis 20: 7.

    • Search Google Scholar
    • Export Citation
  • 6.

    Gutiérrez JM, Rucavado A, Chaves F, Díaz C, Escalante T, 2009. Experimental pathology of local tissue damage induced by Bothrops asper snake venom. Toxicon 54: 958975.

    • Search Google Scholar
    • Export Citation
  • 7.

    Gutiérrez JM, 2010. Snakebite envenomation in Central America. Mackessy SP, ed. Handbook of Venoms and Toxins of Reptiles. Boca Raton, FL: CRC Press, 491507.

    • Search Google Scholar
    • Export Citation
  • 8.

    Gutiérrez JM, Escalante T, Rucavado A, 2009. Experimental pathophysiology of systemic alterations induced by Bothrops asper snake venom. Toxicon 54: 976987.

    • Search Google Scholar
    • Export Citation
  • 9.

    Escalante T, Rucavado A, Fox JW, Gutiérrez JM, 2011. Key events in microvascular damage induced by snake venom hemorrhagic metalloproteinases. J Proteomics 74: 17811794.

    • Search Google Scholar
    • Export Citation
  • 10.

    Luzardo ML, 1962. Aspectos hemorrágicos de las mordeduras de serpientes. Hipofibrinogenemia como hallazgo importante. Investigación Clínica 3: 2930.

    • Search Google Scholar
    • Export Citation
  • 11.

    Singh V, Digra SK, Slathia SS, Kakkar T, 2012. Hemothorax following snakebite. Indian Pediatr 49: 242243.

  • 12.

    Escalante T, Núñez J, Moura-da-Silva AM, Rucavado A, Theakston RDG, Gutiérrez JM, 2003. Pulmonary hemorrhage induced by jararhagin, a metalloproteinase from Bothrops jararaca snake venom. Toxicol Appl Pharmacol 193: 1728.

    • Search Google Scholar
    • Export Citation
  • 13.

    Gutiérrez JM, Calvete JJ, Habib AG, Harrison RA, Williams DJ, Warrell DA, 2017. Snakebite envenoming. Nat Rev Dis Primers 3: 17079.

  • 14.

    Gutiérrez JM, Lomonte B, Sanz L, Calvete JJ, 2014. Immunological profile of antivenoms: preclinical analysis of the efficacy of a polyspecific antivenom through antivenomics and neutralization assays. J Proteomics 105: 340350.

    • Search Google Scholar
    • Export Citation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Case Report: Hemothorax in Envenomation by the Viperid Snake Bothrops asper

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  • 1 Hospital San Francisco, Juticalpa, Honduras;
  • | 2 Instituto Clodomiro Picado, San José, Costa Rica;
  • | 3 Universidad Tecnológica Centroamericana, Tegucigalpa, Honduras
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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.

Author Notes

Address correspondence to Luis José Pinto, Universidad Nacional Autónoma de Honduras, Boulevard Suyapa, Tegucigalpa, Honduras 11101. E-mail: luis.pinto@unah.hn

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.

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