Study of delayed treatment perspective of snake bites and their long-term effects in a tertiary care hospital in balgalkot district of Karnataka

Abstract

Background: Snakebite is an acute life-threatening and time limiting medical emergency. Alternative and traditional methods of cure are barriers to early treatment which results in considerable delay in coming to the hospital. This study was done to assess the clinical profile and to identify long-term perspective of snake bites in patients who presented to the hospital beyond 6 h of snake bite. Methodology: This descriptive study was conducted over 18 months that included 45 patients with alleged history of snake bite of which 15 had delayed presentation, 6 h after snake bite. A detailed history, clinical examination and investigations were monitored for any complications during treatment and follow-up to look for delayed complications. Results: The clinical profile and outcome were different among patients presenting beyond 6 h and within 6 h, cellulitis (46.66% vs. 33.33%), bleeding manifestations (46.66% vs. 50%), neurological manifestations (33.33% vs. 33.33%), AKI (33.33% vs. 16.66%), respiratory failure requiring ventilatory support (33.33% vs. 10%), and mortality (20% vs. none). Delayed complications observed in patients with delayed presentation on long-term follow-up were ulceration including knee amputation, chronic kidney disease, psychiatric disturbances, and musculoskeletal symptoms. Conclusion: The acute complications were significantly higher with delayed presentation and delayed complications that are often overlooked which contributes to significant morbidity and suffering. The general population needs to be educated regarding the available treatment strategies and significance of seeking early medical attention for better treatment outcome and to reduce morbidity and mortality both short term and long term.

Keywords

• acute kidney injury
• anti-snake venom
• delayed treatment
• snake bite