Yalcouyé A, Diallo S H, Diallo S, Landouré G, Bagayoko T, Maiga O, Fomba Z, Djibo D, Guinto C O, Maiga Y
Faculté de médecine et d'odontostomatologie, USTTB, Bamako, Mali.
Service de neurologie, CHU Gabriel Touré, Bamako, Mali.
Med Trop Sante Int. 2021 Jul 29;1(3). doi: 10.48327/mtsibulletin.2021.116. eCollection 2021 Sep 30.
Snakebite envenomation can cause serious damage. Here, we report the case of a six-year-old male child bitten by a snake.
The child presented a gingivorrhagia, abdominal pain, bloody vomiting and severe headache from a snakebite. Neurological examination showed paralysis of the III cranial nerve associated with bilateral blindness and mydriasis, unreactive on the right. The brain scan revealed a left frontal hematoma. The course on antivenom was marked by the disappearance of clinical signs except blindness which remained 18 months after discharge.
DISCUSSION - CONCLUSION: The hemorrhagic syndrome evoked viper bite. Blindness is rarely seen as a result of viperine envenomation. In our case, the presence of intracranial hypertension, absence of ocular lesions and scanner were in favor of compression of the optic nerves which resulted in permanent blindness.
蛇咬伤中毒可造成严重损害。在此，我们报告一例六岁男童被蛇咬伤的病例。
该儿童因蛇咬伤出现牙龈出血、腹痛、血性呕吐及严重头痛。神经学检查显示第三对脑神经麻痹，伴有双侧失明及瞳孔散大，右侧无反应。脑部扫描显示左额叶血肿。使用抗蛇毒血清治疗过程中，除失明外临床症状消失，失明在出院后18个月仍存在。
讨论 - 结论：蝰蛇咬伤引发出血综合征。蝰蛇毒中毒导致失明罕见。在我们的病例中，存在颅内高压、无眼部病变及脑部扫描结果提示视神经受压导致永久性失明。
