Differential Diagnosis of an Unusual Snakebite Presentation in Benin: Dry Bite or Envenomation?

Benjamin, Jordan Max; Chippaux, Jean‐Philippe; Jackson, Kate; Ashe, Sanda; Tamou-Sambo, Bio; Massougbodji, Achille; Akpakpa, Olouchégoun Cardinal; Abo, Benjamin N.

doi:10.55460/yqr3-uzjn

Cited by 4 publications

(5 citation statements)

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“…The latter were, therefore, systematically sought in patients before the administration of IPA. Moreover, additional infection and stress can cause envenoming-like disorders in the absence of venom and/or symptoms similar to antivenom adverse reactions without inoculation [ 10 , 11 ]. That fact may explain the relatively high number of adverse events reported.…”

Section: Discussionmentioning

confidence: 99%

Snakebites in Cameroon: Tolerance of a Snake Antivenom (Inoserp™ PAN-AFRICA) in Africa in Real-Life Conditions

Benhammou,

Chippaux,

Ntone

et al. 2024

Toxins

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Snakebite envenomation (SBE) is a public health issue in sub-Saharan countries. Antivenom is the only etiological treatment. Excellent tolerance is essential in managing SBE successfully. This study aimed to evaluate tolerance of InoserpTM PAN-AFRICA (IPA). It was conducted on fourteen sites across Cameroon. IPA was administered intravenously and repeated at the same dose every two hours if needed. Early and late tolerance was assessed by the onset of clinical signs within two hours and at a visit two weeks or more after the first IPA administration, respectively. Over 20 months, 447 patients presenting with a snakebite were included. One dose of IPA was administered to 361 patients and repeated at least once in 106 patients. No significant difference was shown between the proportion of adverse events in patients who received IPA (266/361, 73.7%) and those who did not (69/85, 81.2%) (p = 0.95). Adverse reactions, probably attributable to IPA, were identified in four (1.1%) patients, including one severe (angioedema) and three mild. All these reactions resolved favorably. None of the serious adverse events observed in twelve patients were attributed to IPA. No signs of late intolerance were observed in 302 patients. Tolerance appears to be satisfactory. The availability of effective and well-tolerated antivenoms would reduce the duration of treatment and prevent most disabilities and/or deaths.

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Section: Discussionmentioning

confidence: 99%

Snakebites in Cameroon: Tolerance of a Snake Antivenom (Inoserp™ PAN-AFRICA) in Africa in Real-Life Conditions

Benhammou,

Chippaux,

Ntone

et al. 2024

Toxins

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“…Some of these atypical presentations of selected elapids mimic venom activities of ophidians in the family Viperidae. This family is principally made up of vipers of varying species and the West African carpet viper ( Echis ocellat us) is reported to cause more deaths than any other snake in sub-Saharan Africa [ 22 , 49 ]. Envenomation from viper bites may result in local and systemic reactions including local pain, swelling/oedema, bruising, blistering, necrosis, haemorrhage, coagulopathy and nephrotoxicity as well as cardiovascular disturbances like hypotension as a sequelae.…”

Section: Discussionmentioning

confidence: 99%

“…The full complement of treating snake bites is beyond the scope of this paper. In considering the use of snake antivenom, choice should be based on clinical presentation and evolution of symptoms rather than on snake identification alone [ 22 ]. Clinicians should also be mindful of reports speaking to the limited activity of antivenoms on local effects of the toxins in contrast to their neutralising effects on systemic manifestations [ 65 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

“…Local presentations may include but not limited to the following: local pain, swelling/ oedema, bruising, blistering, local necrosis, tissue destruction, local bleeding and subcutaneous bleed [18,22,44,[55][56][57].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

“…Systemic presentations are very varied, affecting nearly every organ and organ system of the body. The following have been catalogued as some of the systemic manifestations of venoms with haemorrhagic effects: Bilateral pulmonary embolism, venom induced consumption coagulopathy (VICC) with intracranial haemorrhage (ICH) [22,58], brainstem ischemic stroke [57], acute kidney injury (AKI) and anuric renal failure [55,59], encephalopathy [59], internal bleeding [22], thoracic pain, respiratory failure, systemic bleeding syndrome, haemorrhagic shock, and cardiovascular collapse [22,[59][60][61]. Meanwhile, Cao and colleagues also reported intestinal necrosis following a North American pit viper bite while haematemesis and hypovolaemic shock has also been documented [21].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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Compendium of medically important snakes, venom activity and clinical presentations in Ghana

et al. 2023

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Background Snake bite envenoming (SBE) is one neglected tropical disease that has not received the needed attention. The sequelae of burdensome disability and mortality impact the socioeconomic life of communities adversely with little documentation of SBE in health facility records in Ghana. This study details SBE and snake distribution, habits/habitats, type of venom expressed and clinical manifestations. Methodology We conducted a structured thematic desk review of peer reviewed papers, books and reports from repositories including PubMed, WHO and WCH using bibliographic software EndNote and search engine Google Scholar with the following key words; snakes, medical importance, snake bites, venom and venom type, envenomation, symptoms and signs, vaccines, venom expenditure, strike behaviour and venom-metering + Ghana, West Africa, Africa, World. We also reviewed data from the District Health Information Management System (DHIMS) of the Ghana Health Service (GHS). Outcome variables were organized as follows: common name (s), species, habitat/habit, species-specific toxin, clinical manifestation, antivenom availability, WHO category. Findings Snake bites and SBE were grouped by the activity of the expressed venom into neurotoxic, cardiotoxic, haemorrhagic, cytotoxic, myotoxic, nephrotoxic and procoagulants. Neurotoxic snake bites were largely due to elapids. Expressed venoms with cardiotoxic, haemorrhagic, nephrotoxic and procoagulant activities principally belonged to the family Viperidae. Snakes with venoms showing myotoxic activity were largely alien to Ghana and the West African sub-region. Venoms showing cytotoxic activity are expressed by a wide range of snakes though more prevalent among the Viperidae family. Snakes with neurotoxic and haemorrhagic venom activities are prevalent across all the agro-ecological zones in Ghana. Conclusion/Significance Understanding the characteristics of snakes and their venoms is useful in the management of SBE. The distribution of snakes by their expressed venoms across the agro-ecological zones is also instructive to species identification and diagnosis of SBE.

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A snake bite case: The value of timely diagnosis and treatment

Motawei¹

2019

Clin Case Studie Rep

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Differential Diagnosis of an Unusual Snakebite Presentation in Benin: Dry Bite or Envenomation?

Cited by 4 publications

References 0 publications

Snakebites in Cameroon: Tolerance of a Snake Antivenom (Inoserp™ PAN-AFRICA) in Africa in Real-Life Conditions

Snakebites in Cameroon: Tolerance of a Snake Antivenom (Inoserp™ PAN-AFRICA) in Africa in Real-Life Conditions

Compendium of medically important snakes, venom activity and clinical presentations in Ghana

A snake bite case: The value of timely diagnosis and treatment

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