Hemorrhagic stroke in children caused by Bothrops marajoensis envenoming: a case report

Abstract

According to the World Health Organization, snakebites are considered neglected diseases. Bothrops, the genus most frequently implicated in envenomations in Brazil, includes the species B. marajoensis Hoge, 1966, part of the complex B. atrox, which is found in the savannas of Marajó Island, Pará state, Brazil, a region that presents scarce epidemiological data. This work reports the first case of hemorrhagic stroke in a child, attributed to delayed medical care after snakebite envenoming by Bothrops marajoensis in Anajás city, Marajó Island, Pará, Brazil, which led to permanent hemiplegia as a sequela.

Correlating Fibrinogen Consumption and Profiles of Inflammatory Molecules in Human Envenomation's by Bothrops atrox in the Brazilian Amazon

“…Among these effects, inflammatory and hemostatic disorders are frequently observed in patients. Envenomation's by viperid snakes often cause local and systemic bleeding (9,10), such as gingivorrhagia, epistaxis, hematemesis, hematuria, bleeding in the uteris, and placenta (in pregnant women) (11,12) and bleeding in the central nervous system (13)(14)(15)(16).…”

Hemorrhagic stroke following viper bites and delayed antivenom administration: three case reports from the Western Brazilian Amazon

“…Snake poisonings were recently included by the World Health Organization (WHO) in their list of neglected diseases 1 . Each year, an estimated 5 million cases of envenoming are reported globally 2,3 . In Latin America, there are approximately 129,084 cases per year, most of them caused by species of the Viperidae family.…”

“…Local manifestations are observed mainly as pain, edema, erythema, and systemic manifestations that may include bleeding 6 . Hemorrhagic stroke (HS) is a complication that may be more frequent in patients with pre-existing risk factors, such as diabetes, nephropathies, and cardiovascular diseases 2,6 . In this report, we present a series of three cases of snakebites that evolved with HS due to delays in access to antivenom in the Brazilian Amazon region.…”

Propriedades inflamatórias do veneno da serpente >i<Bitis arietans>/i<: contribuição dos mediadores lipídicos no envenenamento >i<in vivo>/i< e ação de toxinas isoladas do veneno em macrófagos humanos

“…e Dendroaspis spp.). 13 De maneira geral, os acidentes causados por membros da família Viperidae causam coagulopatias, [22][23][24][25] , ao passo que os acidentes elapídicos causam principalmente efeitos neurotóxicos. 26,27 O continente africano abriga diversas espécies de serpentes, embora a maioria delas seja considerada inofensiva.…”

“…Em alguns casos, estas alterações podem desencadear hemorragias graves, incluindo hemorragias intracranianas, as quais são frequentemente fatais. 20,24,25 Com relação aos acidentes com B. arietans, as vítimas podem apresentar efeitos locais e/ou sistêmicos. Os sintomas locais incluem dor intensa, 34,35,38,39 inchaço, 34,35,38,39 formação de bolhas, 34,38 , equimose, 34,35,38 hemorragia no local da picada, que ocorre na presença ou não de coagulopatias, 34,35,38 necrose, 34,35,38 e aumento do tamanho dos linfonodos drenantes.…”