case report

Case report
Case report




Snakebite
Snakebite

Snakebite
Snakebite
•
A 50 years old woman
•
1 day before hospitalization date, she was
bitten on the dorsum of the left foot.
•
2 hours after envenomation, the
symptoms appeared.
•
Ptosis, difficulty in swallowing secretion,
dypnoea, respiratory paralysis
•
She was intubated

Snake bite
Snake bite

On admission:
•
She’s alert, pupil enlargement (cranial
nerve palsy)
•
Generalized flaccid paralysis
•
Respiratory depression (requiring
mechanical ventilation)
•
Local tissue injury: no pain or swelling

Snakebite
Snakebite
Laboratory results:
•
RBC: 4.3; WBC: 15.000, neut 89%,
platelet: 239.000
•
BUN: 2,7; Creat: 64, Na
+
: 135; K
+
: 3.5; Cl
-
:
102; CK: 326
•
No coagulopathy

Snakebite
Snakebite
2 days later:
•
Na
+
: 120, K
+
: 3.4, Cl
-
: 90
•
Serum osmolality: 258
•
Urine osmolality: 974 mosmol/kg
•
Urine Na
+
: 282
•
Urine output: 2,5-3 lit/24h

snakebite
snakebite
Managemant:
•
Normal + Hypertonic saline
•
Hypertonic feedings (salt)
•

Antibiotic
•
Fully recovered
•
Hospitalization course: 9 days
•
Sympathetic stimulating




BUFOTOXIN
BUFOTOXIN

Bufotoxin
Bufotoxin
•
A 42 years old man
•
9
th
, november, 2004, ate bufo meat and
eggs
•
After 15 minutes: abdominal pain, nausea,
vomit, diarrhea.
•
Feel faint, tight in the chest

bufotoxin

bufotoxin
•
ECG:
Management:
•
Decontamination
•
Atropin
•
Spacemaker
•
Fully recovered