Severe tissue complications in patients of Bothrops snakebite at a tertiary health unit in the Brazilian Amazon: clinical characteristics and associated factors

Silva, Flavio Souza; Ibiapina, Hiochelson Najibe Santos; Neves, Juliana Costa Ferreira; Coelho, Kerolaine Fonseca; Barbosa, Fabiane Bianca Albuquerque; Lacerda, Marcus Vinícius Guimarães; Sachett, Jacqueline de Almeida Gonçalves; Malheiro, Adriana; Monteiro, Wuelton Marcelo; Costa, Allyson Guimarães

doi:10.1590/0037-8682-0374-2020

Cited by 12 publications

(3 citation statements)

References 13 publications

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“…The event consists of the local action of venom toxins that are capable of inducing tissue damage, intense local inflammatory reaction, and muscular impairment, in which SVMPs and PLA 2 are important components in this sense ( 107 ). Associated with the low capacity of antivenom neutralization in the region of the bite, the consequence of local effects can cause longer hospitalization periods and, in some cases, the impairment of limb function ( 108 , 109 ). After being bitten by B. bilineatus , the main local manifestations are characterized by edema, increase local temperature, blister formation and secondary infection ( Table 3 ).…”

Section: Envenomation By Bothrops Bilineatus : Pathophysiology and Clinical Aspectsmentioning

confidence: 99%

Bothrops bilineatus: An Arboreal Pitviper in the Amazon and Atlantic Forest

et al. 2021

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The two-striped forest-pitviper (Bothrops bilineatus) is an arboreal snake that is currently represented by two subspecies (B. b. bilineatus and B. b. smaragdinus) that comprise a species complex, and its distribution is in the Amazon and the Atlantic Forest. The rarity of encounters with this snake is reflected in the low occurrence of cases of snakebites throughout its geographic distribution and the resulting low number of published clinical reports. However, in some areas, B. bilineatus proves to be more frequent and causes envenomations in a greater proportion. Herein, we review the main aspects of the species complex B. bilineatus, including its biology, ecology, taxonomy, morphology, genetic and molecular studies, geographic distribution, conservation status, venom, pathophysiology and clinical aspects, and epidemiology. In addition, the different antivenoms available for the treatment of envenomations caused by B. bilineatus are presented along with suggestions for future studies that are needed for a better understanding of the snakebites caused by this snake.

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Section: Envenomation By Bothrops Bilineatus : Pathophysiology and Clinical Aspectsmentioning

confidence: 99%

Bothrops bilineatus: An Arboreal Pitviper in the Amazon and Atlantic Forest

et al. 2021

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“…Snakebites represent a neglected public health problem with high morbidity and mortality rates in tropical and subtropical countries [ 1 , 2 ]. In Brazil, the Bothrops genus is widely distributed, with approximately 29 species throughout the national territory, and in the Brazilian Amazon, Bothrops atrox is responsible for 90% of all cases of venomous snakebite [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

CCL-2 and CXCL-8: Potential Prognostic Biomarkers of Acute Kidney Injury after a Bothrops atrox Snakebite

Neves

Ibiapina

Sachett

et al. 2022

Mediators of Inflammation

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In the Brazilian Amazon, the snake Bothrops atrox is the primary cause of snakebites. B. atrox (BaV) venom can cause systemic pathophysiological changes such as acute kidney injury (AKI), which leads to the production of chemokines and cytokines in response to the envenomation. These soluble immunological molecules act by modulating the inflammatory response; however, the mechanisms associated with the development of AKI are still poorly understood. Here, we characterize the profile of these soluble immunological molecules as possible predictive biomarkers of the development of AKI. The study involved 34 patients who had been victims of snakebites by Bothrops sp. These were categorized into two groups according to the development of AKI (AKI(-)/AKI(+)), using healthy donors as the control (HD). Peripheral blood samples were collected at three-time points: before antivenom administration (T0) and at 24 and 48 hours after antivenom (T1 and T2, respectively). The soluble immunological molecules (CXCL-8, CCL-5, CXCL-9, CCL-2, CXCL-10, IL-6, TNF, IL-2, IL-10, IFN-γ, IL-4, and IL-17A) were quantified using cytometric bead array. Our results demonstrated an increase in CXCL-9, CXCL-10, IL-6, IL-2, IL-10, and IL-17A molecules in the groups of patients who suffered Bothrops snakebites (AKI(-) and AKI(+)) before antivenom administration, when compared to HD. In the AKI(+) group, levels of CXCL-8 and CCL-2 molecules were elevated on admission and progressively decreased during the clinical evolution of patients after antivenom administration. In addition, in the signature analysis, these were produced exclusively by the group AKI(+) at T0. Thus, these chemokines may be related to the initiation and extension of AKI after envenomation by Bothrops and present themselves as two potential biomarkers of AKI at T0.

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“…Generally, SBEs caused by Bothrops snakes are characterized by local (pain, swelling, blisters, and bleeding from the bite site) and systemic (abnormal clotting, spontaneous bleeding and kidney failure) manifestations [ 9 ]. Other complications include bacterial infections, necrosis, compartment syndrome, and amputations [ 10 – 12 ]. To prevent severe cases, antivenom must be administered quickly.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia

et al. 2022

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Snakebite envenomations (SBEs) in pregnant women can result in adverse maternal or neonatal effects, such as abortion, placental abruption, preterm labor, fetal malformations, and maternal, fetal or neonatal deaths. Despite the high incidence of SBEs in the Brazilian Amazon, there is no literature on the impact of SBEs on pregnancy outcomes. The objective of this study was to describe clinical epidemiology and outcomes associated with SBEs in women of childbearing age and pregnant women in the state of Amazonas, Western Brazilian Amazon, from 2007 to 2021. Information on the population was obtained from the Reporting Information System (SINAN), Mortality Information System (SIM) and Live Birth Information System (SINASC) for the period from 2007 to 2021. A total of 36,786 SBEs were reported, of which 3,297 (9%) involved women of childbearing age, and 274 (8.3%) involved pregnant women. Severity (7.9% in pregnant versus 8.7% in non-pregnant women) (P = 0.87) and case-fatality (0.4% in pregnant versus 0.3% in non-pregnant women) rates were similar between groups (P = 0.76). Pregnant women who suffered snakebites were at higher risk for fetal death (OR: 2.17, 95%CI: 1.74–2.67) and neonatal death (OR = 2.79, 95%CI: 2.26–3.40). This study had major limitations related to the completeness of the information on the pregnancy outcomes. Although SBE incidence in pregnant women is low in the Brazilian Amazon, SBEs increased the risk of fetal and neonatal deaths.

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Severe tissue complications in patients of Bothrops snakebite at a tertiary health unit in the Brazilian Amazon: clinical characteristics and associated factors

Cited by 12 publications

References 13 publications

Bothrops bilineatus: An Arboreal Pitviper in the Amazon and Atlantic Forest

Bothrops bilineatus: An Arboreal Pitviper in the Amazon and Atlantic Forest

CCL-2 and CXCL-8: Potential Prognostic Biomarkers of Acute Kidney Injury after a Bothrops atrox Snakebite

Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia

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