Satish Kumar1, Sanghamithra Prabhakaran2
BACKGROUND
The clinical profile and outcome of snake bite varies from place to place and
depends on a number of factors including the type of snake bite, place of snake
bite, time of bite, season, and duration of presentation after bite. The clinical
profile, factors affecting the outcome and the outcome have not been previously
well studied.
METHODS
This is a cross-sectional observational study conducted for a duration of six
months from January 2021 to June 2021. Subjects meeting inclusion
criteria were enrolled in the study group after obtaining written consent.
Patients were evaluated based on the standard pro-forma with detailed
history and clinical examination. All relevant investigations to assess
systemic envenomation, treatment and outcome were documented in all the
patients.
RESULTS
In the study, 204 (68 %) were male patients and 96 (32 %) were female
patients. 108 (36 %) were admitted with venomous snake bite and 192 (64 %)
were with non-poisonous snake bite. 52 patients had snake bite on the upper
extremities, 234 had snake bite on the lower extremities, 8 patients had snake
bite on the trunk whereas 6 patients had bite on other areas of the body. 202
patients had swelling at the bite site, 222 had pain at the site of bite, 86 patients
had oozing of blood and 6 patients had vague somatic symptoms. 132 patients
had local oedema, 148 had local tenderness, 66 patients had skin necrosis and
16 patients developed blisters at the site of bite. 124 patients had systemic
manifestations of which 24 patients had vomiting, 12 patients developed
abdominal pain, 10 patients developed anuria/oliguria, 14 patients developed
hypotension, 12 patients developed bleeding manifestations, 10 patients
developed neurological symptoms and 2 snakebite patients had syncope.
Complications and mortality in poisonous snake bite due to renal failure was
observed in 38 patients with a mortality of 1 patient, 10 patients developed
intravascular haemolysis, 8 patients developed unexplained hypotension, 18
patients developed secondary infection, 4 patients developed intra-cerebral
bleeding and 15 patients developed neurotoxity with a mortality of 2 patients.
CONCLUSIONS
Snake bite is a common problem encountered in tertiary care centres and the
most common encountered type of snakebite was haemotoxic bite. Pain at the
bite site was the commonest symptom and tenderness at bite site was the
commonest sign in patients with snake bite. Mortality in venomous bite was
3.7%. Prolonged bite to needle time, development of renal failure, leukocytosis,
neurotoxicity and severe degree of coagulopathy were factors associated with
adverse outcome.
