Infectious Complications Following Snakebite by Bothrops lanceolatus in Martinique: A Case Series.

Abstract

Infections secondary to snakebite occur in a number of patients and are potentially life-threatening. Bothrops lanceolatus bites in Martinique average 30 cases per year and may result in severe thrombotic and infectious complications. We aimed to investigate the infectious complications related to B. lanceolatus bite. A retrospective single-center observational study over 7 years (2011-2018) was carried out, including all patients admitted to the hospital because of B. lanceolatus bite. One hundred seventy snake-bitten patients (121 males and 49 females) were included. Thirty-nine patients (23%) presented grade 3 or 4 envenoming. Twenty patients (12%) developed wound infections. The isolated bacteria were Aeromonas hydrophila (3 cases), Morganella morganii (two cases), group A Streptococcus, and group B Streptococcus (one case each). Patients were treated empirically with third-generation cephalosporin (or amoxicillin-clavulanate), aminoglycoside, and metronidazole combinations. Outcome was favorable in all patients. The main factor significantly associated with the occurrence of infection following snakebite was the severity of envenoming (P < 0.05). Our findings clearly point toward the frequent onset of infectious complications in B. lanceolatus-bitten patients presenting with grade 3 and 4 envenoming. Thus, based on the bacteria identified in the wounds, we suggest that empiric antibiotic therapy including third-generation cephalosporin should be administered to those patients on hospital admission.

• Authors: Dabor Resiere, Hossein Mehdaoui, Rémi Névière, Claude Olive, Mathieu Severyns, Adeline Beaudoin, Jonathan Florentin, Yannick Brouste, Rishika Banydeen, André Cabié, Bruno Mégarbane, José María Gutiérrez, Hatem Kallel
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 102 Issue 1 Pg. 232-240 (01 2020) ISSN: 1476-1645 [Electronic] United States
• PMID: 31628740 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Animals
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (epidemiology, etiology)
• Bothrops
• Child
• Female
• Humans
• Male
• Martinique (epidemiology)
• Middle Aged
• Snake Bites (complications, epidemiology)
• Wound Infection (microbiology)