A retrospective review of rattlesnake bites in 100 children.
BACKGROUND
A retrospective review of clinical features and treatment of children hospitalized for rattlesnake bite.


METHODS
One hundred clinical records were reviewed. Variables included: age, gender, season of the year, signs, symptoms, poisoning grade, complications, treatment and sequelae.


RESULTS
Fifty-nine percent were males and 37% were less than 5 years of age; 87% occurred in rural areas; 63% of the snakebites occurred during the summer, of them, 39% occurred within the perimeter of the domicile and 8% within the home. Sixty-seven percent of children bitten by snakes reached the second degree of envenomation. During the first period (1977-1996), treatment for intoxication included treatment with polyvalent equine anti-snake venom serum. During the second period (1997-2014, a polyvalent polyclonal horse anti-snake venom F(Ab) was used. The second period hospitalization time was reduced to 3.9 days (P<0.0001). Hematological complications dominated during the first period (P=0.093) with wound infections occurring in 26% of the cases, neurological symptoms in 24 %, fasciotomy in 6% and mortality in 1%. The second degree poisoning was more frequent and was more severe in 7% of the patients. It was determined that the best treatment for snakebite was F(Ab') 2 therapy. Mortality occurred in 1% of the cases.


CONCLUSIONS
Rattlesnake (Crotalus sp.) bite, in Mexico is less frequent as compared to other crotalidae species. The hematological complications are more frequent. We did not observe any recurrent phenomenons.
Department of Medicine and Health Sciences, University of Sonora, Children's Hospital of the State of Sonora (HIES), Hermosillo, Sonora, Mexico - nsotelo51@gmail.com.
Norberto
N
Sotelo-Cruz
Emergency Service, Children's' Hospital of the State of Sonora (HIES), Hermosillo, Sonora, Mexico.
Norberto
N
Gómez-Rivera
D000293:Adolescent; D000818:Animals; D000997:Antivenins / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003435:Crotalid Venoms / Q000037:antagonists & inhibitors; D017839:Crotalus; D005260:Female; D006736:Horses; D006760:Hospitalization; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D012621:Seasons; D012909:Snake Bites / Q000453:epidemiology* / Q000628:therapy
D000997:Antivenins; D003435:Crotalid Venoms; D007140:Immunoglobulin Fab Fragments