de Roodt Adolfo Rafael, De Titto Ernesto, Dolab Jorge Adrián, Chippaux Jean-Philippe
Laboratorio de Toxinopatología, Centro de Patología Experimental y Aplicada, Facultad de Medicina, Universidad de Buenos Aires, CABA, Argentina.
Rev Inst Med Trop Sao Paulo. 2013 Jan-Feb;55(1):13-8. doi: 10.1590/s0036-46652013000100003.
Envenomation by coral snakes (Micrurus sp.) is one of the most dangerous injuries in America and it is considered as a serious medical emergency, however bites by these snakes appear to be rare. We analyzed epidemiological data, clinical signs and antivenom use in Argentina during the period between 1979-2003. During this period of study 46 non-fatal Micrurus bites were reported. The majority of cases were men from 31 to 40 years old. Bites occurred primarily in spring and summer. Most cases were reported from the northeast and northwest provinces of the country. The bites were mostly located on hands or feet and occurred mostly during agricultural activities and so mainly involved farmers. Only four cases occurred as a result of handling snakes. The median time it took for antivenom to be administrated was 60 minutes after the bite, and the median number of vials applied was 2. Local pain was mentioned and edema was reported in 41% of patients. All patients recovered without sequelae. This study showed a low incidence of Micrurus bites and low severity of envenomation. However, although no deaths have been reported during the last 30 years, given the toxicity of the venom of Micrurus snakes, the risk of severe envenomation should be considered.
珊瑚蛇(小盾鼻蛇属)咬伤是美洲最危险的伤害之一,被视为严重的医疗急症,不过这些蛇的咬伤似乎较为罕见。我们分析了1979年至2003年期间阿根廷的流行病学数据、临床症状及抗蛇毒血清的使用情况。在此研究期间,共报告了46例非致命的小盾鼻蛇咬伤病例。大多数病例为31至40岁的男性。咬伤主要发生在春季和夏季。大多数病例报告来自该国的东北部和西北部省份。咬伤大多位于手部或足部,主要发生在农业活动期间,因此主要涉及农民。只有4例是因处理蛇而发生的。抗蛇毒血清给药的中位时间为咬伤后60分钟,使用的中位瓶数为2瓶。41%的患者提到有局部疼痛并报告出现水肿。所有患者均康复且无后遗症。这项研究表明小盾鼻蛇咬伤的发生率较低且中毒严重程度较低。然而,尽管在过去30年中未报告死亡病例,但鉴于小盾鼻蛇毒液的毒性,仍应考虑严重中毒的风险。