Abstract
BackgroundIn Africa, snakebite envenomations are frequently complicated by life-threatening hemorrhagic syndromes. The authors of the present study conducted a prospective analysis at the University Hospital of Parakou (north of Benin) for seven months (January 1 to July 31, 2014) to assess the contribution of ultrasonography to the diagnosis of internal bleedings and management of envenomation.MethodsAn ultrasound examination was performed in all patients with clinical envenomation regardless of its severity. The study involved 32 patients admitted to the ICU of the University Hospital of Parakou.ResultsThe average age was 27 ± 13.9 years. The main signs of severity were: prolongation of clotting time (88 %), severe anemia (41 %), clinical hemorrhage (47 %), and shock (19 %). The ultrasound imaging showed internal hemorrhage in 18 patients (56 %). There were hematomas (22 %), hemoperitoneum (13 %) or a combination of both (22 %). The occurrence of internal bleeding and hemoperitoneum were mainly related to the delay of hospital presentation (p = 0.007) and the existence of external bleeding (p = 0.04). Thirty patients (94 %) received antivenom. Case fatality rate was 3.1 %.ConclusionUltrasonography may help in diagnosing internal bleeding, even in patients that did not show external hemorrhages, and evaluating its importance. As a consequence, the management of snakebite victims may be significantly improved.
Highlights
In Africa, snakebite envenomations are frequently complicated by life-threatening hemorrhagic syndromes
In northern Benin, over 70 % of envenomations are due to Echis ocellatus (West African carpet viper), a small and abundant viper whose venom contains hemorrhagins and prothrombin activators that provoke severe bleedings [2]
The study was performed in the Intensive Care Unit (ICU) and Department of Medical Imaging of the University Hospital of Parakou (UHP) in North Benin
Summary
In Africa, snakebite envenomations are frequently complicated by life-threatening hemorrhagic syndromes. Snakebite envenomations are an actual neglected public health issue in tropical regions, in northern Benin, because of their high incidence and severity of clinical presentations [1, 2]. In northern Benin, over 70 % of envenomations are due to Echis ocellatus (West African carpet viper), a small and abundant viper whose venom contains hemorrhagins and prothrombin activators that provoke severe bleedings [2]. Internal bleeding generally affect cavities and soft tissues of the organism (dermis, muscle, deep organs). Their clinical diagnosis is difficult and they often cause death, in remote health centers where most envenomations occur [6]. It is essential to diagnose them early, including with the use of medical imaging exams such as Tchaou et al Journal of Venomous Animals and Toxins including Tropical Diseases (2016) 22:13
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