1. Infectious Complications Following Snakebite by Bothrops lanceolatus in Martinique: A Case Series
- Author
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Dabor Resiere, Hatem Kallel, Bruno Mégarbane, Jonathan Florentin, José María Gutiérrez, Mathieu Severyns, André Cabié, Hossein Mehdaoui, Adeline Beaudoin, Yannick Brouste, Claude Olive, Remi Neviere, and Rishika Banydeen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bothrops lanceolatus ,medicine.drug_class ,030231 tropical medicine ,Cephalosporin ,Snake Bites ,medicine.disease_cause ,Group B ,03 medical and health sciences ,0302 clinical medicine ,Virology ,Internal medicine ,medicine ,Animals ,Humans ,Bothrops ,Martinique ,Child ,0303 health sciences ,biology ,030306 microbiology ,Streptococcus ,business.industry ,Articles ,Bacterial Infections ,Middle Aged ,biology.organism_classification ,3. Good health ,Anti-Bacterial Agents ,Metronidazole ,Infectious Diseases ,Wound Infection ,Parasitology ,Female ,Morganella morganii ,business ,medicine.drug - 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.
- Published
- 2019