Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura 50008, Sri Lanka.
Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
J Venom Anim Toxins Incl Trop Dis. 2014 Aug 11;20:33. doi: 10.1186/1678-9199-20-33. eCollection 2014.
Snakebite is a common occupational health hazard among Sri Lankan agricultural workers, particularly in the North Central Province. Viperine snakes, mainly Russell's viper envenomation, frequently lead to acute renal failure. During the last two decades, an agrochemical nephropathy, a chronic tubulointerstitial disease has rapidly spread over this area leading to high morbidity and mortality. Most of the epidemiological characteristics of these two conditions overlap, increasing the chances of co-occurrence. Herein, we describe four representative cases of viperine snakebites leading to variable clinical presentations, in patients with chronic agrochemical nephropathy, including two patients presented with acute and delayed anuria. These cases suggest the possibility of unusual manifestations of snakebite in patients with Sri Lankan agrochemical nephropathy, of which the clinicians should be aware. It could be postulated that the existing scenario in the Central America could also lead to similar clinical presentations.
蛇咬伤是斯里兰卡农业工人常见的职业健康危害，尤其是在中北部省。蝰蛇咬伤，主要是罗素氏蝰蛇中毒，常导致急性肾衰竭。在过去的二十年中，一种农用化学肾病，一种慢性肾小管间质性疾病，迅速在该地区蔓延，导致高发病率和死亡率。这两种情况的大多数流行病学特征重叠，增加了同时发生的可能性。在此，我们描述了四起具有代表性的蝰蛇咬伤病例，这些病例导致了患有慢性农用化学肾病的患者出现不同的临床表现，包括两名患者表现为急性和延迟性无尿。这些病例提示在患有斯里兰卡农用化学肾病的患者中，蛇咬伤可能出现不寻常的表现，临床医生应有所了解。可以推测，中美洲目前的情况也可能导致类似的临床表现。
