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Venomous snakebites in the Croatian North Dalmatia region

Giftige Schlangenbisse in der kroatischen Nord-Dalmatien Region

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Zusammenfassung

ZIEL DER STUDIE: Analyse der epidemiologischen, klinischen und labormäßigen Attribute von giftigen Schlangenbissen mit dem Ziel, die rechtzeitige und wirksame Behandlung vor Ort oder im klinischen Setting zu ermitteln. METHODEN: Es wurden die epidemiologischen und klinischen Daten sowie die Laborergebnisse der Leute, die im Zeitraum von 11 Jahren (1999–2009) von giftigen Schlangen gebissen und im Allgemeinen Krankenhaus von Zadar behandelt worden waren, retrospektiv analysiert. ERGEBNISSE: Im untersuchten Zeitraum sind 93 Leute (57 (62 %) Männer und 36 (38 %) Frauen) von giftigen Schlangen gebissen worden. In 82 Fällen (90 %) war der Biss auf den Extremitäten der Patienten lokalisiert. Die restlichen 11 Patienten wurden an anderen Stellen gebissen. Bei 31 Patienten (33 %) erfolgte der Biss bei der Ausübung von Freizeitaktivität, bei 44 (47,3 %) während der Arbeit. Die häufigsten lokalen Zeichen des Schlangenbisses sind Schwellung und Schmerz an der Biss-Stelle (bei 100 %) sowie Hämatome und Ekchymosis (87 Patienten = 89 %). Acht der gebissenen Patienten erlitten ein Kompartment Syndrom und eine Person (0,97 %) verstarb. SCHLUSSFOLGERUNGEN: Die Gegengift-Behandlung zur Vorbeugung möglicher allergischer Reaktionen eines Schlangenbisses sollte in der medizinischen Institution, in die das Opfer gebracht wird, stattfinden. Wenn aber der Transport nicht gleich möglich ist oder das Opfer bereits Zeichen der Vergiftung zeigt, sollte die Gegengift-Behandlung sofort (vor Ort) erfolgen, da ihre Wirkung schwächer ist, wenn das Gift bereits wirkt.

Summary

AIM: The aim of this research project is to analyze the epidemiological, clinical and laboratory attributes of venomous snakebites and to ascertain the timely and efficient treatment at the location where the incident took place or in varying clinical conditions. METHODS: Epidemiological, clinical and laboratory data were collected from people who were bitten by venomous snakes as well as treatments at Zadar General Hospital during a span of eleven years (1999–2009) which were analyzed retrospectively. RESULTS: During that period, 93 people were bitten by venomous snakes of which 57 patients (62%) were male and 36 (38%) were female. In 82 cases (90%), the bite area was localized on the limbs while in the remaining 11 cases the bite area was located elsewhere. At the time of the venomous snakebite, 31 (33%) patients were performing leisure activities and 44 (47.31%) of them were at work. The most common local snakebite signs are swelling and pain at the bite site (93 patients; 100%), hematomas and ecchymoses (87 patients; 89%). Of the affected patients, 8 suffered from compartment syndrome and one person (0.97%) expired. CONCLUSION: Antivenom treatment for preventing possible allergic reactions should take place at the medical institution where the victim was transported. However, when transport is not immediately available or in cases where the victim shows clear signs of envenomation, antivenom treatment should be used immediately because its effect is weaker if the venom is allowed to run its course.

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Authors and Affiliations

  1. Department of Surgery, Zadar General Hospital, Zadar, Croatia

    Robert Karlo, Ivan Bačić , Tihomir Dunatov, Ante Kanjer, Rade Škarica & Srećko Sabalić

  2. Department of Infectious Diseases, Zadar General Hospital, Zadar, Croatia

    Boris Dželalija

  3. Department of Pediatric Surgery, Children's Hospital Zagreb, Zagreb, Croatia

    Božidar Župančić

  4. Department of Pediatric Surgery, Clinical Hospital Center Rijeka, Rijeka, Croatia

    Nado Bukvic & Harry Nikolić

  5. Department of Surgery, Division of Abdominal Surgery, University Hospital Center Zagreb, Zagreb, Croatia

    Goran Augustin

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  1. Robert Karlo
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  2. Boris Dželalija
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  3. Božidar Župančić
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  4. Ivan Bačić
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  5. Tihomir Dunatov
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  6. Ante Kanjer
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  7. Rade Škarica
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  11. Goran Augustin
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Correspondence to Robert Karlo.

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Karlo, R., Dželalija, B., Župančić , B. et al. Venomous snakebites in the Croatian North Dalmatia region. Wien Klin Wochenschr 123, 732–737 (2011). https://doi.org/10.1007/s00508-011-0085-x

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  • DOI: https://doi.org/10.1007/s00508-011-0085-x

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