Enfermedad del suero secundaria a suero antiofídico

Meregildo-Rodríguez, Edinson Dante; Vásquez-Tirado, Gustavo Adolfo; Asmat-Rubio, Martha Genara

doi:10.17843/rpmesp.2020.371.4883

Cited by 1 publication

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“…Serum sickness is a type III hypersensitivity ( Johansson et al, 2001 ) that occurs due to an IgG-based antibody response of the patient to horse proteins recognized as foreign. Although it is usually a mild condition, the incidence of serum sickness is poorly known, especially since patients do not return to medical centers or do not associate the manifestations with a reaction to antivenom treatment ( Abubakar et al, 2010 ; Meregildo-Rodriguez et al, 2020 ). In our records, the mean elapsed time to the appearance of serum sickness was seven days, longer than the time in the hospital for many of the patients.…”

Section: Discussionmentioning

confidence: 99%

New insights into snakebite epidemiology in Costa Rica: A retrospective evaluation of medical records

Sasa

Cano

2020

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Continuous monitoring of the snakebite envenoming allows elucidating factors that affect its incidence at spatial and temporal scales, and is a great tool to evaluate the proper management of snakebite in health centers. To determine if there have been changes over time in snakebite epidemiology in Costa Rica, we conducted a retrospective study using medical records from six hospitals for the years 2012–2013. A total of 475 snakebite patients were treated at the selected hospital during this period. Most bites occurred during the rainy season and primarily affected young men, mainly farm workers and schoolchildren. About 55% of bites occur in peri-domiciliary environments, although its prevalence varies geographically. Bothrops asper generates the vast majority of envenoming in the country, which is why the main local symptoms registered are edema, pain, and bleeding disorders. The time elapsed until treatment did not explain the degree of severity at admission. However, complications were observed more frequently in patients who took longer to receive treatment. The primary complications were bacterial infections, whereas kidney failure and compartment syndrome documented at very low frequencies. Only one death was recorded, reflecting the low fatality rate exhibited in the country. Hospital treatment included the rapid administration of antivenom and complementary treatment of antibiotics, analgesics, and antihistamines. The application of the latter as prophylactic does not seem to prevent the appearance of mild early adverse reactions, registered in 22.5% of the cases. Morbidity and mortality rates from snakebite have continued to decrease in the country, as a result of the efforts that Costa Rica has made to improve its public health system. Among those efforts, the creation of primary care centers (EBAIS) has reduced the time to treatment in many regions of the country. The Costa Rican experience of using antivenom in primary health care centers and maintaining good medical records could be considered for application in other countries where snakebite is a major health problem.

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Section: Discussionmentioning

confidence: 99%