Clinical characterization of snakesbites in a Colombian hospital, 2004–2014

In Colombia snakebite is considered a public health problem issue that causes mortality in 8% and disability in 10% of cases due to inadequate clinical attention. The objective was to describe the clinical-epidemiological characteristics of patients diagnosed with snakebite in a tertiary hospital in Colombia. A review of the clinical charts with diagnosis of ophidism during the 2004-2014 period was made at the La Samaritana Empresa Social del Estado, University Hospital. The frequency of the variables associated with snake bites, previous treatment and in-hospital management was analyzed. Results: 42 medical charts were reviewed. It was found that 98% of the patients were bitten by family Viperidae´s snakes and 1% by coral´s snakes. 76% of cases occurred in male farmers, 53% with bites in lower limbs, 72% initially attended by healers. 63% of the cases were classified as moderate, 28% severe and 7% mild. 95.2% of the patients received antivenom, however, there was a discrepancy between the classification of severity and the antivenom doses required. 92% of patients had an adverse reaction to antivenom serum, 26% anaphylactic shock. Ninety percent of patients had intrainflammatory superinfection, mostly intradermal and skeletal muscles, 30% had wound culture, 74% received antibiotic. 50% of patients received fasciotomy, however, no patient had intracompartimental pressure measurement. The high incidence of infections despite the antibiotic scheme and surgical procedures reevaluated in snakebites. The medical treatment of the snakebites must be continuously updated to reduce disability and mortality in patients.