A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia

Abstract

BackgroundAlthough the majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed.MethodsTo determine the demographic characteristics, we conducted a retrospective study on all snakebite patients admitted to the Emergency Department of Hospital Universiti Sains Malaysia (HUSM) from January 2006 to December 2010.ResultsIn the majority of the 260 cases that we found (138 cases or 52.9%), the snake species was unidentified. The most common venomous snakebites among the identified species were caused by cobras (52 cases or 20%). Cobra bites are significantly more likely to result in severe envenomation compared to non-cobra bites. Post hoc analysis also showed that cobra bite patients are significantly less likely to have complete recovery than non-cobra bite patients (48 cases, 75.0% vs. 53 cases, 94.6%; p = 0.003) and more likely to result in local gangrene (11 cases, 17.2% vs. 3 cases, 5.4%; p = 0.044).ConclusionCobra bites are significantly more likely to result in severe envenomation needing anti-venom administration and more likely to result in local gangrene, and the patients are significantly less likely to have complete recovery than those with non-cobra bites.

Venomics of the beaked sea snake, Hydrophis schistosus: A minimalist toxin arsenal and its cross-neutralization by heterologous antivenoms

“…There is hardly local inflammation or local tissue destruction such as dermal necrosis, contrary to bites inflicted by cobras, king cobra and pit vipers found in this region [4,8,10].…”

“…There are more than 20 species of sea snakes in Malaysian waters [9]; envenomation cases by sea snake have been reported sporadically but are not uncommon [8,10]. The beaked sea snake, Hydrophis schistosus, is one of the most commonly encountered species in this region.…”

Effectiveness of early fasciotomy in the management of snakebites

“…Ölüme kadar varabilen komplikasyonlara neden olabileceğinden, tüm yılan ısırık-ları zehirli kabul edilerek izlenmelidir. [20] Kan basıncı kontrol altına alınmalı, kan sayımı, kandaki fibrinojen düzeyi, trombosit sayısı, serum elektrolitleri, kan glukozu, BUN, kreatinin, KCFT, amilaz, CPK, PT, PTT, TİT ve arteriyel kan gazları incelenmelidir. EKG çe-kilmeli ve incelemeler 8-12 saat arayla tekrarlanmalıdır.…”

Pattern and pharmacotherapy of acute poisonings presenting to a tertiary care centre

“…Although the identification of species of snake is very crucial for optimal and effective clinical management. 46 In present study, types of snakes could not be identified as either there was no mention of it in the case records or the description could have been misleading.…”

“…26 The hospitalization period was for a median duration of 4 days. 46.7% (178) of patients with poisoning required intensive care for a mean duration of 3.11±2.8 days. Out of those patients in ICU, 28.3% (108) needed mechanical ventilation for a mean duration of 2.0±1.4 days.…”