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A retrospective review of rattlesnake bites in 100 children
Norberto Sotelo-Cruz1, Norberto Gómez-Rivera2
1Department of Medicine and Health Sciences, University of Sonora, Children's Hospital of the State of Sonora (HIES), Hermosillo, Sonora, Mexico - nsotelo51@gmail.com.
Insights
Pediatric rattlesnake bites are more common in males and young children, often occurring in rural areas during summer. F(Ab')2 therapy significantly reduced hospitalization time for snakebite treatment.
Area of Science:
- Pediatric Toxicology
- Herpetology
- Clinical Medicine
Background:
- This study reviews clinical features and treatment of pediatric rattlesnake bites.
- Focuses on understanding the epidemiology and outcomes of snakebites in children.
Purpose of the Study:
- To analyze clinical characteristics and treatment outcomes of children hospitalized for rattlesnake envenomation.
- To evaluate the effectiveness of different antivenom treatments over time.
Main Methods:
- Retrospective review of 100 clinical records of children with rattlesnake bites.
- Analysis of variables including demographics, bite circumstances, clinical signs, envenomation grade, complications, and treatment.
Main Results:
- Pediatric rattlesnake bites predominantly affected males (59%) and children under 5 (37%), often in rural summer settings.
- F(Ab rading_sign)2 antivenom therapy (1997-2014) significantly reduced hospitalization duration compared to earlier treatments.
- Hematological complications were frequent, with wound infections (26%) and neurological symptoms (24%) noted; mortality was 1%.
Conclusions:
- Rattlesnake bites in Mexico are less common than other Crotalidae species, with hematological complications being more frequent.
- F(Ab rading_sign)2 therapy is identified as the optimal treatment for pediatric rattlesnake envenomation.
- No recurrent phenomena were observed in the studied cases.
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.
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