title: Venomous snakebites in children in southern Croatia.
abstract: This retrospective study represents observation of 160 children and adolescents aged up to 18 years that experienced venomous snakebites in southern Croatia and were treated in the Clinical Department of Infectious Diseases in the University Hospital Centre Split from 1979 to 2013. The main purpose of this research was to determine the epidemiological characteristics, clinical presentation, local and general complications, and received treatment. Most bites occurred during warm months, from early May to late August (80%), mostly in May and June. Upper limb bites were more frequent (59%) than lower limb bites (40%). Out of the total number of poisoned children, 24% developed local, and 25% general complications. The most common local complications were haemorrhagic blisters that occurred in 20% children, followed by compartment syndrome presented in 7.5% patients. The most dominated general complication was cranial nerve paresis or paralysis, which was identified in 11.2% patients, whereas shock symptoms were registrated in 7% children. According to severity of poisoning, 9.4% children had minor, 35% mild, 30.6% moderate, and 24.4% had severe clinical manifestation of envenomation. Only one (0.6%) child passed away because of snakebite directly on the neck. All patients received antivenom produced by the Institute of Immunology in Zagreb, tetanus prophylaxis as well, and almost all of them received antibiotics, and a great majority of them also received corticosteroids and antihistamines. Neighter anaphylactic reaction nor serum disease were noticed in our patients after administrating antivenom. A total of 26% children underwent surgical interventions, and incision of haemorrhagic blister was the most common applied surgical treatment, which was preformed in 15.6% patients, while fasciotomy was done in 7.5% subjects. All of our surgically treated patients recovered successfully.
authors.affiliation: Clinical Department of Infectious Diseases, University Hospital Centre Split, Šoltanska 1, Split, Croatia. Electronic address: svjetlana.karabuva@gmail.com.
authors.forename: Svjetlana
authors.initials: S
authors.lastname: Karabuva
authors.affiliation: Clinical Department of Infectious Diseases, University Hospital Centre Split, Šoltanska 1, Split, Croatia. Electronic address: ivanav20@gmail.com.
authors.forename: Ivana
authors.initials: I
authors.lastname: Vrkić
authors.affiliation: Department of Pharmacology, Mostar University School of Medicine, Bijeli brijeg bb, Mostar, Bosnia and Herzegovina. Electronic address: ivicabrizic@net.hr.
authors.forename: Ivica
authors.initials: I
authors.lastname: Brizić
authors.affiliation: Clinical Department of Infectious Diseases, University Hospital Centre Split, Šoltanska 1, Split, Croatia; University of Split School of Medicine, Šoltanska 2, Split, Croatia. Electronic address: iivic@kbsplit.hr.
authors.forename: Ivo
authors.initials: I
authors.lastname: Ivić
authors.affiliation: Clinical Department of Infectious Diseases, University Hospital Centre Split, Šoltanska 1, Split, Croatia; University of Split School of Medicine, Šoltanska 2, Split, Croatia. Electronic address: boris.luksic1@st.t-com.hr.
authors.forename: Boris
authors.initials: B
authors.lastname: Lukšić
mesh_terms: D000293:Adolescent; D000818:Animals; D000832:Animals, Poisonous / Q000254:growth & development*; D000997:Antivenins / Q000009:adverse effects / Q000627:therapeutic use; D001768:Blister / Q000209:etiology / Q000517:prevention & control; D002648:Child; D003131:Combined Modality Therapy / Q000009:adverse effects; D003161:Compartment Syndromes / Q000209:etiology / Q000517:prevention & control; D003391:Cranial Nerves / Q000503:physiopathology; D017523:Croatia / Q000453:epidemiology; D000071938:Fasciotomy / Q000009:adverse effects; D005260:Female; D006474:Hemorrhagic Disorders / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D010291:Paresis / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012909:Snake Bites / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D012911:Snakes / Q000254:growth & development*
chemical_list: D000997:Antivenins
keywords: Antivenom; Children; Compartment syndrome; Croatia; Snakebite; Viper venom