title: Snake bite and antivenom complications in Belo Horizonte, Brazil.
abstract: Factors associated with clinical complications of snake bite and antivenom therapy were studied in 310 hospital patients admitted with snake bite over 6 years to a tertiary referral hospital in Belo Horizonte, southeast Brazil. Overall, 17.4% had early clinical complications including tissue loss associated with abscess and necrosis, acute renal failure, shock, acute lung oedema and intracranial haemorrhage. 3% had permanent sequelae, caused by muscle contractures and amputations, chronic renal failure, or death. Early complications were associated with the following: age under 9 years (P = 0.04), residence in a rural area (P = 0.04), and a delay of more than 8 h in seeking clinical care (P < 0.01). Antivenom was administered to 98.1% of patients; 13.8% presented with anaphylaxis and 11.8% with pyrexia. Individuals from a rural area had a higher occurrence of anaphylactic reactions (P = 0.03). Neither anaphylaxis nor pyrexia was linked with antivenom type and dosage. This study suggested that antivenom might be associated with a reduced risk of serious injuries related to snake bite, especially when administered within the first 8 h. Complications appeared to be a far greater risk than adverse reactions to the antivenom.
authors.affiliation: Fundação Ezequiel Dias, Research and Development Centre, Belo Horizonte, MG, Brazil.
authors.forename: W T
authors.initials: WT
authors.lastname: Caiaffa
authors.forename: D
authors.initials: D
authors.lastname: Vlahov
authors.forename: C M
authors.initials: CM
authors.lastname: Antunes
authors.forename: H R
authors.initials: HR
authors.lastname: de Oliveira
authors.forename: C R
authors.initials: CR
authors.lastname: Diniz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000707:Anaphylaxis / Q000209:etiology; D000997:Antivenins / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012424:Rural Population; D012909:Snake Bites / Q000150:complications*; D013997:Time Factors
chemical_list: D000997:Antivenins