Snake Envenomation in North-West Iran: A Three-Year Clinical Study

Abstract

Background: Snakebite is a medical emergency and must receive high-priority assessment and treatment, even in patients who initially appear well. A few reports have been published regarding snakebite in Iran. This study aimed to assess the snakebite cases in a tertiary teaching hospital in the northwest of Iran. Methods: We assessed demographic and clinical characteristics of adult patients who were admitted because of snakebite into Ayatollah Taleghani Teaching Hospital, Urmia, West Azerbaijan, Iran, between January 1, 2012, and December 31, 2014. After institutional Ethics Committee approval, the required data were extracted, analyzed, and reported. Results: Totally, 60 snakebite cases were recorded during three years study period, of them 63.3% were male. The patients’ Mean±SD age was 37.8±15.8 years. The majority of snake envenomations occurred in the farms and mountains (71.4%), frequently in the afternoons of spring and summer seasons, and mostly affected inhabitants or visitors of the rural areas. The Mean±SD time interval between snake envenomation and admission to the first health center was 15.3±28.6 hours. The anatomic sites of the snakebite were lower and upper extremities in most instances (96.6%). Only 5 (8.3%) patients had severe toxicity, and 2 patients underwent surgical fasciotomy. The patients were treated using antihistamines (n=45), corticosteroids (n=35), antibiotics (n=54), polyvalent snake antivenins (n=50), wound care and tetanus immunization (n=39). The Mean±SD number of polyvalent snake antivenins used for each patient was 3.3±1.9 (range, 1-8) vials. There was no in-hospital fatality. Conclusion: Most snakebites victims in the northwest of Iran were men in their productive age. Early diagnosis and proper use of snake antivenins could be life-saving and should be encouraged.