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Snakebite Envenomation in Central and South America

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Critical Care Toxicology

Abstract

Snakebites can cause life-threatening injuries, sometimes requiring intensive care. The most important snakebites occurring in Latin America are provoked by species of the family Viperidae (Bothrops, Crotalus, and Lachesis) and Elapidae (genus Micrurus). Viperid venoms induce prominent local tissue pathology, which may lead to permanent sequelae and systemic disturbances associated with coagulopathies, bleeding, hemodynamic alterations, and acute kidney injury. Elapid snake venoms, and South American rattlesnake venoms, induce neurotoxic manifestations associated with paralysis of various muscles, including respiratory muscles. Treatment of envenomation is based on parenteral administration of antivenoms. Severely envenomed patients need an adequate life support therapy such as treatment of shock, assisted ventilation, and renal therapy replacement.

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Authors and Affiliations

  1. Vital Brazil Hospital, Instituto Butantan, Av. Vital Brasil, 1500, 05503-900, São Paulo, Brazil

    Ceila Maria Sant’Ana Malaque

  2. Intensive Care Unit, Instituto de Infectologia Emilio Ribas, São Paulo, Brazil

    Ceila Maria Sant’Ana Malaque

  3. Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica

    José María Gutiérrez

Authors
  1. Ceila Maria Sant’Ana Malaque
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  2. José María Gutiérrez
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Correspondence to Ceila Maria Sant’Ana Malaque .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies, and case reports, or reports of expert committees.

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Sant’Ana Malaque, C.M., Gutiérrez, J.M. (2015). Snakebite Envenomation in Central and South America. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_146-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_146-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-20790-2

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

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