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Type: Artigo de periódico
Title: Compartment Syndrome After South American Rattlesnake (crotalus Durissus Terrificus) Envenomation.
Author: Bucaretchi, F
De Capitani, E M
Hyslop, S
Mello, S M
Fernandes, C B
Bergo, F
Nascimento, F B P
Abstract: In order to report the outcome of a patient who developed compartment syndrome after South American rattlesnake (Crotalus durissus terrificus) envenomation, confirmed by subfascial pressure measurement and magnetic resonance imaging (MRI). A 63-year-old male was admitted 1 h after being bitten on the right elbow by a large snake, which was not brought for identification. Physical and laboratory features upon admission revealed two fang marks, local tense swelling, paresthesia, intense local pain, hypertension, coagulopathy, and CK = 1530 U/L (RV < 170 U/L). The case was initially treated with bothropic antivenom (80 mL, intravenously), with no improvement. Evolution within 13-14 h post-bite revealed generalized myalgia, muscle weakness, palpebral ptosis, and severe rhabdomyolysis (CK = 126,160 U/L) compatible with envenoming by C. d. terrificus. The patient was then treated with crotalic antivenom (200 mL, intravenously), fluid replacement, and urine alkalinization. Twenty-four-hour post-bite MRI showed marked muscular edema in the anterior compartment of the right forearm, with a high subfascial pressure (40 mmHg) being detected 1 h later. ELISA of a blood sample obtained upon admission, before antivenom infusion, revealed a high serum concentration of C. d. terrificus venom. No fasciotomy was performed and the patient was discharged seven days later without sequelae. Snakebite by C. d. terrificus with subfascial venom injection may lead to increased intracompartmental pressure.
Subject: Animals
Compartment Syndromes
Crotalid Venoms
Magnetic Resonance Imaging
Middle Aged
Snake Bites
Compartment Syndrome
Crotalus Durissus Terrificus
Magnetic Resonance Imaging
Citation: Clinical Toxicology (philadelphia, Pa.). v. 52, n. 6, p. 639-41, 2014-Jul.
Rights: fechado
Identifier DOI: 10.3109/15563650.2014.913177
Date Issue: 2014
Appears in Collections:Unicamp - Artigos e Outros Documentos

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