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Galan LEB, Silva VS, Silva VS, Monte RC, Jati SR, Oliveira IS, Cerni FA, Monteiro WM, Sachett J, Dantas DSM, Carbonell RCC, Pucca MB. Acute mesenteric ischemia following lancehead snakebite: an unusual case report in the Northernmost Brazilian Amazon. Front Med (Lausanne) 2023; 10:1197446. [PMID: 37425310 PMCID: PMC10323676 DOI: 10.3389/fmed.2023.1197446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Snakebites have a great impact in the Brazilian Amazon, being the lancehead Bothrops atrox the species responsible for most accidents, disabilities, and deaths. This study shows a case report of an indigenous patient from the Yanomami ethnicity, male, 33 years-old, envenomed by a B. atrox snake. Envenoming caused by B. atrox are characterized by local manifestations (e.g., pain and edema) and systemic manifestations, mainly coagulation disorders. The indigenous victim was admitted in the main hospital of Roraima and evolved with an unusual complication, an ischemia and necrosis of the proximal ileum, requiring segmental enterectomy with posterior side-to-side anastomosis. The victim was discharge after 27 days of hospitalization with no complaints. Snakebite envenomations may evolve with life-threatening complications, which can be treated by the antivenom following access to a healthcare unit, often late in indigenous population. This clinical case shows the need of strategies that aim improvement in the access to the healthcare by indigenous people, as well as demonstrates an unusual complication that may result from lancehead snakebites. The article also discusses the decentralization of snakebites clinical management to indigenous community healthcare centers to mitigate complications.
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Affiliation(s)
- Luis E. B. Galan
- Medical School, Federal University of Roraima, Boa Vista, Roraima, Brazil
| | | | | | - Rommel C. Monte
- Medical School, Federal University of Roraima, Boa Vista, Roraima, Brazil
| | - Sewbert R. Jati
- Post Graduate Program in Tropical Medicine (PPGMT) of the State University of Amazonas, Manaus, Amazonas, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Isadora S. Oliveira
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Felipe A. Cerni
- Post Graduate Program in Tropical Medicine (PPGMT) of the State University of Amazonas, Manaus, Amazonas, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Wuelton M. Monteiro
- Post Graduate Program in Tropical Medicine (PPGMT) of the State University of Amazonas, Manaus, Amazonas, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Jacqueline Sachett
- Post Graduate Program in Tropical Medicine (PPGMT) of the State University of Amazonas, Manaus, Amazonas, Brazil
- Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil
| | - Domingos S. M. Dantas
- Programa Doutoral de Bioética da Faculdade de Medicina do Porto, Cidade do Porto, Portugal
| | | | - Manuela B. Pucca
- Post Graduate Program in Tropical Medicine (PPGMT) of the State University of Amazonas, Manaus, Amazonas, Brazil
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University, Araraquara, São Paulo, Brazil
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