title: Comparison of Bothropoides jararaca bites with and without envenoming treated at the Vital Brazil Hospital of the Butantan Institute, State of São Paulo, Brazil.
abstract: BACKGROUND
  This study analyses the cases of all bites (including dry bites) caused by Bothropoides jararaca attended at the Vital Brazil Hospital of the Butantan Institute, State of São Paulo, Brazil.
  
  
  METHODS
  A retrospective study was conducted of patients bitten by Bothropoides jararaca (n=792) from January 1990 to December 2004. The characteristics of the snake specimen, data related to the accident and clinical manifestations on admission were obtained from patient medical records.
  
  
  RESULTS
  The majority of the cases in this study were caused by female and juvenile snakes. No stomach contents were found in 93.4% of the snake specimens after dissection. No statistical difference was observed between the occurrence of dry bites and the maturity or sex of the snake. The median SVL of snakes in mild and moderate cases was 40.5 cm and in severe cases, SVL increased to 99 cm. Necrosis was more common in the digits of the feet and hands (4.8%) compared to the other body regions (1.8%). A significant difference was verified between severity and a time interval greater than six hours from the bite to hospital admission. A significant association was verified between gingival bleeding and abnormal blood coagulability. In accidents caused by adult snakes, necrosis was more frequent (7.2%) compared to accidents caused by juvenile snakes (1%).
  
  
  CONCLUSIONS
  In this work, the association between certain epidemiological data and the evolution of biological parameters in the clinical course of Bothrops sensu latu accidents were highlighted, contributing to the improvement of snake bite assistance.
authors.affiliation: Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Alessandra Furtado
authors.initials: AF
authors.lastname: Nicoleti
authors.forename: Carlos Roberto de
authors.initials: CR
authors.lastname: Medeiros
authors.forename: Marcelo Ribeiro
authors.initials: MR
authors.lastname: Duarte
authors.forename: Francisco Oscar de Siqueira
authors.initials: FO
authors.lastname: França
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D017837:Bothrops; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D012720:Severity of Illness Index; D012909:Snake Bites / Q000453:epidemiology* / Q000473:pathology; D013997:Time Factors