Clinical, Laboratory, and Therapeutic Aspects of Crotalus durissus (South American Rattlesnake) Victims: A Literature Review

Abstract

Snakebite envenoming is a neglected public health issue in many tropical and subtropical countries. To diagnosis and treat snakebites may be challenging to health care personnel since sufficient information has not been yet provided. This review presents the clinical, therapeutic, and laboratory aspects of Crotalus durissus (South American rattlesnakes) victims. The clinical setting may show local effects such as little or no pain, mild edema, and recurrent erythema. In contrast, the systemic effects may be quite remarkable, such as changes due to neurological damage, intense rhabdomyolysis, incoagulability of the blood, and variations in the peripheral blood elements. The main complication is acute kidney injury. The appropriate treatment depends mainly on the correct recognition of the aggressor snake and the symptoms expressed by the victim. Rattlesnake venom can cause irreparable damage and lead to death. Therefore, a prompt diagnosis allows the immediate onset of proper serotherapy.

Fatal Rattlesnake Envenomation in Northernmost Brazilian Amazon: A Case Report and Literature Overview

“…The Brazilian Ministry of Health recommends the administration of 5 ampoules of Cav for mild, 10 ampoules for moderate, and 20 ampoules for severe crotalic envenomations [23]. Our patient did not receive the recommended 20 vials for severe envenomations due to the limited antivenom available at that moment.…”

“…On the other hand, LDH level was examined. LDH increase is low and gradual, representing an important parameter for late diagnosis of severe crotalic envenomation [23].…”

“…Rattlesnake case reports, as well as current reviews [23,35], have been alerting the medical community about the great diversity during case evolution. Pardal et al (2007) reported a moderate case of a 19-year-old boy who was bitten by a rattlesnake and sought medical attention 12 h after the accident, due to the appearance of classic symptoms.…”

Crotalus Durissus Ruruima: Current Knowledge on Natural History, Medical Importance, and Clinical Toxinology

“…Specific antivenom is crucial for the efficiency of the treatment of rattlesnake envenomings ( 154 ). For the treatment of Crotalus envenomings in areas where C. d. ruruima occurs, there are three types of antivenoms, two produced in Brazil and one in Venezuela.…”

Paediatric snakebite envenoming: recognition and management of cases

“…Some viperid species, such as the South American rattlesnake, also induce neuromuscular paralysis. 14 A number of Australian elapid venoms also cause coagulopathy. 15 Systemic manifestations of many viperid envenomings are typically associated with coagulopathy and bleeding, owing to the disruption of microvessel wall integrity by venom proteinases 16 and to a consumption coagulopathy.…”