Clinical profile and outcome of snake bite in children

Abstract

Background: Snake bite is generally considered to be a rural problem and has been linked with environmental and occupational condition is a neglected public health problem. This study was conducted to ascertain clinical profile, complication and outcome of snake bite in pediatric population. Methods:Retrospective observational study was done in paediatrics wards and Paediatric Intensive care unit of tertiary care institute. A medical record files of 80 patients of snakebite, between the periods of January 2011 to February 2016 were recovered from Medical Record and Statistics Section of Institute. Files were analyzed for demographic data; variables included site of bite, time of bite, type of primary treatment and treatment provider, and type of snake poison, common symptoms suggestive of hematotoxicity, myotoxicity and neurotoxicity.Results: Out of total 80 patients, 58.75% were male and most of snake bites were seen in age group of 6-12 years. Clinically 57.5% patients were presented with signs and symptoms of envenomation and most of them were bitten during the months of June to September. All bites were nonprovocative and in 57.5% lower limb was the commonest site of bite. A 77.5% patient were primarily treated by medical personnel, 56.25% patients were received treatment within 1 hour of bite and hospitalized within 6 hours of bite. Coagulation failure was commonest complication (58.33%) followed by hypotension (25%) in vasculotoxic snake bite and respiratory paralysis (68.18%) in neuroparalytic bites. Renal replacement therapy was required in 5%, blood/blood product transfusion in 11% patients and case fatality rate was 11.25%.Conclusions: The most vulnerable to snake bites are boys aged more than 5 years. There is an urgent need to spread awareness among the community for avoidance of traditional treatment and any delay in medical intervention in snakebite incidents.

Clinicoepidemiology, clinical profile and outcome of venomous snake bite in children in Konaseema region of Andhra Pradesh, India

“…5,6 Lower limbs were the common site of snake bite this finding corroborates with the work of Jayakrishnan M et al and Jasjit Singh et al 8,9 Regarding time of the bite, it was higher on the evening between 6pm to 6am. This supported by the work of Rajkumar M et al, Meshram et al and Roshini KK et al 10,11 Regarding clinical profile of the patient local pain was present in all patients, oedema at the site of bite was also very common that is 97%, and bleeding from the site of bite was found in 64.28%. This finding is supported by the work of Virendra C et al, Patil et al and Rajesh K et al 12,13 Forty % patients presented with cellulites in our study, this finding in not supported by the study of Khirsagar et al 4 But our study is supported by the work of Virendra C. Patil et al 12 Ptosis was present in 7.3% which is similar to the finding of Rajesh K et al 13 Dyspnoea was present in 14.28% present which nearly collaborates with the finding of Virendra C. Patil et al 12 In present study pain abdomen was found in 11.42% patients of total snake bite patients, this finding was observed by others also Kavitha S et al, found it 10%, but in Rekha Thapar study incidence it was 1.5%.…”

“…13,16 Among all the patient treated with ASV(anti snake venom) only one patient developed reaction to anti snake venom, which corroborates with the finding of Khirsajar et al 4 Acute renal failure was also found in 1.4% of the patient, which corroborates with the finding of Patil B et al 18 Most of the patient treated with ASV and under ICU (intensive care unit) were recovered the percentage of death was 1.5% this is similar to the finding of khirsagar et al, that is 1.81%, as per data of Meshram RM et al, it was 11.25%. 4,10…”

Unwitnessed Snake Bite in Children - A Challenge in Diagnosis and Management: A Case Report

“…There was a higher risk of fatalities in victims of snakebite who reported to the hospital after more than six hours of the bite incident, among which majority died within 10 hours of hospitalization [1].…”

“…Snakebites are commonly non-provocative in nature and there was a reported higher frequency of incidences during night times [1]. Lower limb was the commonest site of bites [1] as majority of snakebite cases are due to accidental stepping while walking or playing in the dark. Primary treatment includes the administration of antisnake venom and the tetanus toxoid.…”

“…There is various mode of clinical presentations in snakebite patients, which may either suggest a vasculotoxic or neuroparalytic nature of the afflicted snakebite. In neuroparalytic bites, patients may present with altered sensorium, bilateral ptosis or complaining of diplopia within 8 hours of the bite event [1]. Progression of the systemic envenomation may result in respiratory failures, requiring ventilatory support.…”