Jijith Krishnan
BACKGROUND Snake bites can be deadly if not treated quickly. A study was conducted to identify the clinical and laboratory profile of snake bite envenomation and to assess the risk factors of mortality. MATERIALS AND METHODS This was a cross-sectional observational study which included all patients with snake bite envenomation admitted to a tertiary care center in Kerala during January 2015 to December 2015. Clinical features, laboratory parameters, complications and outcome of snake bite were studied. RESULTS A total of 56 patients were admitted with envenomation. Most of the patients (24) were in age group of 30-50 years and 17 patients were above 50 years. Majority of patients were males (58.9%). Among the 56 patients with envenomation, 89.2% (50) of the patients had haemotoxic envenomation and rest (6) of them had neurotoxic bites. Majority of bites were during day time (60.7%). Major symptoms of snake bite envenomation were swelling (62.5%), bleeding from site (30.4%), redness (25%), vomiting (19.6%), abdominal pain (12.5%). Neurotoxic signs of snake bites were ptosis (66.7%), ophthalmoplegia (16.7%) and dysphagia (16.7%). Out of 56 patients, 12% (6) developed anaphylaxis after anti-snake venom (ASV). Dialysis was required in 19.6% and mechanical ventilation required in 7.1% of patients. There were 5 (8.9%) deaths; all of them belonged to haemotoxic envenomation. Oliguria, mechanical ventilation, leukocytosis, the time between bite and treatment-more than 24 hours was associated with poor outcome. CONCLUSION Haemotoxic envenomation was more common. The time between bite and treatment alters the prognosis. Mortality was observed only in haemotoxic envenomation. Oliguria, leukocytosis and mechanical ventilation were associated with poor outcome.
