M A Berdai1, S Labib1, M Harandou1. 1. CHU Hassan II, Service de Réanimation mère et enfant, 30000 Fès, Maroc.
Abstract
AIMS: The objective of our study is to describe the epidemiological, clinical, biological, and therapeutic aspects of snake bites in children in northern Morocco. METHODS: This retrospective study reviewed files of all children admitted to the pediatric intensive care unit of the Hasssan II University Hospital in Fez from April 2011 through April 2013. It includes all children reported by themselves or their family to have been bitten by a snake and all those with traces of snake fangs. RESULTS: This study included 12 children, with a mean age of 9.6 ± 2.9 years. In each case, admission took place the day the envenomation occurred, a mean of 8.8 ± 5.6 hours after the bite. Locoregional signs and edema were seen in all cases, associated with bruising (58%) and blisters (25%). General events, including gastrointestinal, cardiovascular, neurologic, and hemorrhagic signs, affected 83% of the children. Hemostasis disorders occurred in 91% of patients, including profound thrombocytopenia (mean: 27.7 ± 30.7 G/L. All envenomations were grade 2 or grade 3. Analgesia was administered systematically; a fasciotomy was performed in 25% of cases and transfusion of blood products in 66%. Three children (25%) were intubated and two children died (16%). CONCLUSION: This series is characterized by the severity of the clinical presentations, with a predominance of locoregional complications and hemostasis disorders corresponding to snake-bite syndrome. We conclude that immunotherapy adapted to the local species must be made available to improve the prognosis of this envenomation.
AIMS: The objective of our study is to describe the epidemiological, clinical, biological, and therapeutic aspects of snake bites in children in northern Morocco. METHODS: This retrospective study reviewed files of all children admitted to the pediatric intensive care unit of the Hasssan II University Hospital in Fez from April 2011 through April 2013. It includes all children reported by themselves or their family to have been bitten by a snake and all those with traces of snake fangs. RESULTS: This study included 12 children, with a mean age of 9.6 ± 2.9 years. In each case, admission took place the day the envenomation occurred, a mean of 8.8 ± 5.6 hours after the bite. Locoregional signs and edema were seen in all cases, associated with bruising (58%) and blisters (25%). General events, including gastrointestinal, cardiovascular, neurologic, and hemorrhagic signs, affected 83% of the children. Hemostasis disorders occurred in 91% of patients, including profound thrombocytopenia (mean: 27.7 ± 30.7 G/L. All envenomations were grade 2 or grade 3. Analgesia was administered systematically; a fasciotomy was performed in 25% of cases and transfusion of blood products in 66%. Three children (25%) were intubated and two children died (16%). CONCLUSION: This series is characterized by the severity of the clinical presentations, with a predominance of locoregional complications and hemostasis disorders corresponding to snake-bite syndrome. We conclude that immunotherapy adapted to the local species must be made available to improve the prognosis of this envenomation.
Entities:
Keywords:
Morocco; anti venom; child; ophidian envenomation; snake