Surucucu Accident (Lachesis sp) in the State of Ceará: Case report
Keywords:
Lachesis muta; Snake bites; Compartment syndromes.Abstract
The Lachesis muta snake, known as "surucucu" or "pico-de-jaca", is the largest venomous snake in Latin America, reaching up to 4.5 meters in length. Due to their habitat preference, especially in humid forest domains, human poisonings are not common. The objective of this study was to report a case of snake poisoning, caused by a snake of the genus Lachesis, attended at the Information and Toxicological Assistance Center of Ceará (CIATox-CE). A 43-year-old male patient from the rural area of Pacoti-Ceará was the victim of a serious snakebite accident on his right hand, on July 15, 2020. He arrives at the specialized hospital network 23 hours after the accident, where he receives the diagnosis of laquetic poisoning serious, based on the patient's description of the snake, clinical manifestations and laboratory test results. The treatment instituted was administration of 20 vials of Anti-Botropic/Laquetic Serum (SABL). The patient evolved with compartment syndrome in the right upper limb, with a minimum and reversible degree of acute kidney injury and acquired coagulopathy, which normalized within a few hours after serotherapy and administration of blood components, which made it possible to perform fasciotomy. The patient had a favorable clinical outcome. It can be concluded that the delay in seeking specialized care contributed to the worsening of the patient's clinical condition.
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ANDRADE FILHO, A., CAMPOLINA, D., DIAS, M. B. Ofidismo. In:____. Toxicologia na prática clínica. 2.ed. Belo Horizonte: Folium, 2013. p. 491-510.
BORGES-NOJOSA, D.M.; LIMA-VERDE, J.S. Lachesis muta rhombeata. Geographic distribution. Herpetological Review. v.30, n.4, p.235, 1999.
BRASIL. Ministério da Saúde. Manual de diagnóstico e tratamento de acidentes por animais peçonhentos. 2. ed. Brasília: Fundação Nacional de Saúde, 2001.
DE LIMA, P. H. S.; JUNIOR, V.H. A snakebite caused by a bushmaster (Lachesis muta): report of a confirmed case in State of Pernambuco, Brazil. Rev. Soc. Bras. Med. Trop. [Internet]. v.48, n.5, p.636-637, 2015. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S003786822015000500636&lng=en. Acesso em: 21 dez. 2020.
DINIZ-SOUSA, R. et al. A brief review on the natural history, venomics and the medical importance of bushmaster (Lachesis) pit viper snakes. Toxicon. v. 7, 2020.
FEITOSA, R. F. G.; MELO, I. M. L. A.; MONTEIRO, H. S. A. Epidemiologia dos acidentes por serpentes peçonhentas no Estado do Ceará - Brasil. Rev. Soc. Bras. Med. Trop. [Internet]. v.30, n.4, p.295-301, agosto, 1997. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S003786821997000400004&lng=en. Acesso em: 21 dez. 2020.
FRANÇA, F.O.S; MÁLAQUE, C.M.S;. Acidente botrópico. In: CARDOSO, J.L.C. et al. Animais peçonhentos no Brasil: biologia, clínica e terapêutica dos acidentes. São Paulo: Sarvier, FAPESP, 2009. p.81-95.
GARNER, M.R. et al. Compartment Syndrome: Diagnosis, Management, and Unique Concerns in the Twenty-First Century. HSS J. v. 10, n.2, p. 143-152, 2014.
LIMA-VERDE, J.S. Estado Atual do Conhecimento sobre a Fauna Reptiliana do Ceará. Tese de Concurso para Professor Titular. Universidade Federal do Ceará, 1991.
MOTA-DA-SILVA, A.; MONTEIRO, W.M.; BERNARDE, P.S. Popular names for bushmaster (Lachesis muta) and lancehead (Bothrops atrox) snakes in the Alto Juruá region: repercussion to clinical-epidemiological. Rev. Soc. Bras. Med. Trop., Uberaba, v. 52, e-20180140, 2019. Disponível em <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S003786822019000100605&lng=pt&nrm=iso>. Acesso em 14 fev. 2021.
MOTA DA SILVA, A. et al. Epidemiological and clinical aspects of snakebites in the upper Juruá River region, western Brazilian Amazonia. Acta Amaz. v.50, n.1, 2020.
PARDAL, P. P. O. et al. Clinical trial of two antivenoms for the treatment of Bothrops and Lachesis bites in the north eastern Amazon region of Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene. v.98, n.1, p.28-42, 2004.
PARDAL, P. P. O. et al. Snake bite by the bushmaster (Lachesis muta muta) in Belém-Pará: a case report. Revista Paraense de Medicina. v.21, n.1,p.37-42, 2007.
ROSENTHAL, R. et al. Intestinal ischemia after bushmaster (Lachesis muta) snakebite – a case report. Toxicon. v.40, n.2, p.217-220, 2002.
SANCHEZ, E.F. et al. Resolution of isoforms of mutalysin II, the metalloproteinase from Bushmaster snake venom. Toxicon. v. 41, n.8, p. 1021–1031, 2003.
SOUZA, R.C.G. Aspectos clínicos do acidente laquético. In: CARDOSO, J.L.C.C. et al. Animais Peçonhentos do Brasil: biologia, clínica e terapêutica dos acidentes. 2.ed. São Paulo: Elsevier, 2009. p. 96-107.
STRANSKY, S. et al. In vitro assessment of cytotoxic activities of Lachesis muta muta snake venom. PLoS Neglected Tropical Diseases. v.12, n. 4, p. 1-17, april, 2018.
TAVARES, A. V. et al. The epidemiology of snakebite in the Rio Grande do Norte State, Northeastern Brazil. Rev. Inst. Med. trop. S. Paulo [Internet], v. 59, e52. 2017. Disponível em: https://www.scielo.br/scielo.php?pid=S0036-46652017005000227&script=sci_abstract. Acesso em: 21 dez. 2020.
ZANOTTY, Y. et al. Mutacytin-1, a New C-Type Lectin-Like Protein from the Venezuelan Cuaima (Lachesis muta muta Linnaeus, 1766) (Serpentes: Viperidae) Snake Venom Inducing Cardiotoxicity in Developing Zebrafish (Danio rerio) Embryos. Zebrafish. v. 16, n. 4, p. 379-387, 2019.
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