CLINICAL MANIFESTATIONS OF SNAKEBITE BY THE BUSHMASTER SNAKE Lachesis muta muta IN MANAUS, AMAZONAS, BRAZIL

Souza, A.R.B., Muniz, E.G., López-Lozano, J.L., Ferreira, L.C.L., Noronha, M.D.N.

Gerência de Animais Peçonhentos, Fundação de Medicina Tropical, Instituto de Medicina Tropical do Amazonas Manaus, Amazonas, Brasil

Ten cases of Lachesis snakebites, attended in the hospital of the Fundação de MedicinaTropical, Instituto de Medicina Tropical do Amazonas (FMT/IMT-AM), Manaus – Amazonas, Brazil, between 1986 and 1996, were studied. Nine patients brought the snakes that were identified as Lachesis muta muta. One of these accidents was diagnosed by ELISA method. Clinical manifestations of the accidents were studied from the patients’ records. Pain, swelling, erythema, light hemorrhages were the principal manifestations in snakebite region. These patients no showed bullae, necrosis or systemic hemorrhages. Four patients present one or more signals of vagal stimulation: blurred vision, hyper salivation, nausea, vomiting (in four patients), abdominal pain, diarrhea, shock, bradycardia (one patient showed blood pressure: 70x00 mmHg and cardiac rate: 64). Three accidents were classified as light, because they did not show hemorrhage in snakebite region, systemic hemorrhages or neurotoxic manifestations and edema restricted in snakebite region. Three accidents were classified as middle and three as severe. The blood was incoagulable in four patients and change in blood coagulation time was detected in three patients. Only one patient presented normal coagulation time. Urea and creatinine in plasma were normal in all the patients studied. Two patients received Lachesis antivenom,four patients received Bothrops-Lachesis antivenom. One patient received 19 flasks of bothropic antivenoms and the blood was incoagulable for 15 days. There was no death in all studied patients.

CORRESPONDENCE TO:

Emiro Gutzmann Muniz, Avenida Pedro Teixeira 25, Manaus, AM, CEP: 69040-000, Brasil, Email: ofidismo@prodamnet.com.br