Acidentes laquéticos na Amazônia brasileira: aspectos clínicos e ecoepidemiológicos

Abstract

Introduction: Ophidismsynonymous with snakebitescomprises envenomation cases resulting from snakebites. These cases are divided into four basic types in Brazil: bothropic, crotalic, elapidic, and laquetic. Objective: This article aims to describe and discuss the most relevant aspects of envenomation by Lachesis in the Brazilian Amazon. Methodology: To fulfill the objective, a literature review was conducted using the search strategy defined in the Lilacs, Scielo, and Pubmed databases. This search allowed the discussion of the following topics: (1) biology of snakes of the genus Lachesis, (2) ecology and epidemiology of laquetic accidents, (3) pathogenesis, (4) natural history and clinical presentation, (5) differential diagnosis, (6) laboratory evaluation, (7) therapeutic approach, and (8) prophylaxis and control. Results: Laquetic venom presents proteolytic, hemorrhagic, and coagulant activity, with reported neurotoxic action and related clinical alterations. Conducts should be based on information obtained through complete anamnesis, detailed clinical observation, and laboratory tests (especially coagulation time). Antilaquetic serum (ALS) or antibothropic-laquetic serum (ABLS) should be administered as early as possible to promote a positive impact on the victim's clinical evolution. Conclusion: Preventive measures should be adopted to minimize the risk of encounters between Homo sapiens and Lachesis and, consequently, the occurrence of envenomation.