Document Detail

Snakebites by Crotalus durissus ssp in children in Campinas, São Paulo, Brazil.
MedLine Citation:
PMID:  12163905     Owner:  NLM     Status:  MEDLINE    
From January, 1984 to March, 1999, 31 children under 15 y old (ages 1-14 y, median 8 y) were admitted after being bitten by rattlesnakes (Crotalus durissus ssp). One patient was classified as "dry-bite", 3 as mild envenoming, 9 as moderate envenoming and 18 as severe envenoming. Most patients had neuromuscular manifestations, such as palpebral ptosis (27/31), myalgia (23/31) and weakness (20/31). Laboratory tests suggesting rhabdomyolysis included an increase in total blood creatine kinase (CK, 28/29) and lactate dehydrogenase (LDH, 25/25) levels and myoglobinuria (14/15). The main local signs and symptoms were slight edema (20/31) and erythema (19/31). Before antivenom (AV) administration, blood coagulation disorders were observed in 20/25 children that received AV only at our hospital (incoagulable blood in 17/25). AV early reactions were observed in 20 of these 25 cases (9/9 patients not pretreated and 11/16 patients pretreated with hydrocortisone and histamine H1 and H2 antagonists). There were no significant differences in the frequency of patients with AV early reactions between the groups that were and were not pretreated (Fisher's exact test, p = 0.12). Patients admitted less than and more than 6 h after the bite showed the same risk of developing severe envenoming (Fisher's exact test, p = 1). No children of the first group (< 6 h) showed severe complications whereas 3/6 children admitted more than 6 h post-bite developed acute renal failure. Patients bitten in the legs had a higher risk of developing severe envenoming (Fisher's exact test, p = 0.04). There was a significant association between both total CK and LDH blood enzyme levels and severity (p < 0.001 for CK and p < 0.001 for LDH; Mann-Whitney U test). No deaths were recorded.
Fábio Bucaretchi; Sílvia Regina Fontoura Herrera; Stephen Hyslop; Emílio Carlos Elias Baracat; Ronan José Vieira
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revista do Instituto de Medicina Tropical de São Paulo     Volume:  44     ISSN:  0036-4665     ISO Abbreviation:  Rev. Inst. Med. Trop. Sao Paulo     Publication Date:    2002 May-Jun
Date Detail:
Created Date:  2002-08-06     Completed Date:  2002-10-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7507484     Medline TA:  Rev Inst Med Trop Sao Paulo     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  IM    
Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
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MeSH Terms
Antivenins / therapeutic use
Child, Preschool
Crotalid Venoms / poisoning*
Prospective Studies
Snake Bites / blood,  diagnosis*,  therapy
Reg. No./Substance:
0/Antivenins; 0/Crotalid Venoms

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