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Long-term sequelae secondary to snakebite envenoming: a single centre retrospective study in a Costa Rican paediatric
Helena Brenes-Chacon1,2, Jose M Gutierrez3, Kattia Camacho-Badilla1,2
1Universidad de Ciencias Medicas (UCIMED), San Jose, Costa Rica.
Insights
Long-term health issues, including scars and limb limitations, affect children after snakebites. Early complications like infection and compartment syndrome increase the risk of these serious sequelae.
Area of Science:
- Pediatric Medicine
- Toxicology
- Public Health
Background:
- Snake envenoming causes severe acute symptoms, but long-term effects, especially in children, are poorly understood.
- Understanding these sequelae is crucial for effective patient management and resource allocation.
Purpose of the Study:
- To characterize the clinical features of long-term health problems in children following snakebite envenoming in Costa Rica.
Main Methods:
- A retrospective descriptive study was conducted.
- Data were collected from pediatric patients under 13 years old admitted for snakebite envenoming between 2001 and 2014.
- Patients were categorized based on the development of sequelae.
Main Results:
- Out of 74 patients, 24 developed long-term sequelae.
- Acute complications like local wound infection and compartment syndrome were more frequent in the sequelae group.
- Common sequelae included hypertrophic scars (66.7%), functional limb limitation (37.5%), and need for skin grafts (37.5%).
- Median follow-up for patients with sequelae was 25.4 months; no deaths occurred.
Conclusions:
- Snakebite envenoming in children can lead to significant long-term health issues.
- Preventing factors associated with sequelae is essential due to the substantial burden on individuals and healthcare systems.
Objectives:
Although devastating acute effects associated with snake envenoming are well described, the long-term sequelae resulting from these envenomings have not been adequately addressed, especially in the paediatric population. The aim of our study is to describe the clinical characteristics among paediatric patients in Costa Rica who developed long-term sequelae secondary to snakebite envenoming.
Design:
Retrospective descriptive study of paediatric patients under 13 years who were admitted with a history of a recent snakebite at the National Children's Hospital in Costa Rica from January 2001 to December 2014.
Results:
We enrolled 74 patients admitted to our centre due to envenoming, and separated those who did not develop sequelae (50 patients) from those who did (24 patients). Of those who presented acute complications during hospitalisation, local wound infection and clinically diagnosed compartmental syndrome were significantly higher in the group that developed sequelae thereafter. Hypertrophic scars (66.7%), functional limitation of affected limb (37.5%) and the need of skin graft (37.5%) were the most common sequelae. The median follow-up of patients with long-term sequelae after discharge was 25.4 months (5.6-59.4). No deaths were reported during this time period.
Conclusions:
Given the high economic, personal and healthcare burden that entails follow-up of these patients, efforts should be carried out to prevent the factors associated with sequelae among the affected population.
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