Bothrops envenomation in dogs: local and systemic manifestations

Background: Snakebite envenoming is a condition that affects humans and domestic animals worldwide. Identification of the snake species involved in the envenomation is infrequent. Bothrops envenomation presents typical clinicopathological features. This report describes epidemiological, clinical, and pathological data of 2 cases of Bothrops envenomation in dogs, including the first case of Bothrops moojeni snake striking a domestic animal in Brazil. Cases: Case 1. A dog was witnessed to have a Bothrops moojeni snakebite on a farm. In the first 24 h, acute lameness, pain, diffuse swelling, focal bleeding at the left forelimb, and increased whole-blood clotting time were observed in the envenomed dog. Polyvalent antivenom was administered in addition to fluid therapy, analgesics, corticosteroids, and antibiotics. On the 5th day, the animal presented spontaneous bleeding at the wound site, thrombocytopenia, and increased whole-blood clotting time. An additional dose of polyvalent antivenom was administered, and local treatment at the snakebite site was initiated. After 13 days, the dog showed no clinical or laboratory changes and recovered entirely. Case 2. A mongrel dog was taken for a necropsy to determine the cause of death. Grossly, major findings included swelling in the nasal plane that extended to the neck and dissecting hemorrhage in the subcutaneous tissue and adjacent musculature. Hemorrhages were observed in the heart, parietal pleura, left forelimb, lumbar region, and perirenal tissue. Marked necrosis and disruption of small blood vessels and lymphatics within the deep dermis and subcutaneous tissue were the main microscopic findings close to the snakebite site. Additionally, degeneration and necrosis of muscle fibers and dissecting hemorrhage were observed in the head and neck tissues surrounding the snakebite site. Kidneys showed marked interstitial hemorrhage and acute tubular nephrosis. Discussion: Bothrops envenoming is characterized by local (hemorrhage, dermonecrosis, and myonecrosis) and systemic (coagulative disorders, systemic hemorrhage, and acute kidney injury) changes due to the effect of the main venom components such as phospholipase A2 and metalloproteinases. These changes are hallmarks for the bothropic envenomation, supporting the diagnosis in cases 1 and 2. In case 1, the dog developed a Bothrops moojeni snakebite envenomation, but the immediate treatment with antivenom allowed a favorable outcome. In case 2, gross and microscopic findings supported the presumptive diagnosis of fatal bothropic envenomation. A marked local reaction such as swelling, pain, bleeding, bruising, and tissue necrosis was observed in case 1. In case 2, the most significant local changes were swelling and edema at the head and neck, hemorrhage in the subcutaneous tissue, and adjacent musculature. Systemic effects were observed clinically as spontaneous bleeding, thrombocytopenia, increased whole-blood clotting time (Case 1), systemic hemorrhages, and acute tubular nephrosis (Case 2). A proper treatment probably prevented the development of acute renal failure in Case 1. Herein, we show the first case of accidental snakebite envenomation by B. moojeni in a dog in Brazil. Information is scarce on the identification of venomous snake species striking domestic animals. Fast detection of well-determined clinical and pathological findings of Bothrops envenomation is essential for a correct diagnosis, therapeutics, and a good prognosis, even in cases with an unknown history.

Retrospective analysis of dog bites in Southern Italy / Análise retrospectiva de mordidas de cães no sul da Itália

Dog bite is one of the major public health problems involving people worldwide. Although, several studies have investigated this phenomenon in different countries, little information about the incidence of dog bite episodes in Italy is available. We analysed data about dog biting events between 2010 and 2019 provided by the CRIUV, the Regional Reference Centre for Veterinary Urban Hygiene in the largest city of Southern Italy, namely. Naples. We observed severe and profound inconsistencies in the data collection that reveal structural and significant weaknesses of the current data collection system. Given the multifactorial nature of dog bite, we highlight the need to improve the gathering of all the information related to the factors affecting the occurrence of biting episodes for an accurate assessment of the biting phenomenon.

A mordida de cães é um dos maiores problemas de saúde pública que envolve pessoas em todo o mundo. Embora vários estudos tenham investigado esse fenômeno em diferentes países, poucas informações sobre a incidência de episódios de mordidas por cães na Itália estão disponíveis. Analisamos dados sobre eventos de mordidas de cães entre 2010 e 2019 fornecidos pelo CRIUV, Centro de Referência Regional para Higiene Veterinária Urbana na maior cidade do sul da Itália, Nápoles. Observamos inconsistências graves e profundas na coleta de dados que revelam fragilidades estruturais e significativas do sistema de coleta de dados atual. Dada a natureza multifatorial da mordida canina, destaca-se a necessidade de melhorar a coleta de todas as informações relacionadas aos fatores que afetam a ocorrência de episódios de mordida para uma avaliação precisa deste fenômeno.

Investigación del evento adverso asociado a la vacunación antirrábica / Investigation of adverse event following immunization associated with antirabies vaccine / Investigação de evento adverso associado à vacinação antirrábica

La rabia es una antropozoonosis endémica en Brasil. El animal infectado transmite el virus de la rabia principalmente a través de mordeduras. Durante muchos años, los perros y gatos representaron la principal fuente de infección para los humanos en las zonas urbanas. Desde 1973, el Programa Nacional de Profilaxis de la Rabia ha establecido que los perros y gatos deben ser inmunizados contra la rabia. La vacunación animal es una forma segura, fiable y eficaz de proteger a los animales contra enfermedades infecciosas y prevenir la transmisión de zoonosis, sin embargo, la administración de vacunas no está exenta de riesgos. Por lo tanto, se debe investigar la ocurrencia de eventos adversos asociados con la vacunación, ya que la demostración de la seguridad de la vacuna contribuyó al éxito de los programas de inmunización. Este estudio describe el reporte de un caso de un animal sospechoso de tener una reacción adversa a la vacunación antirrábica.

Rabies is an endemic anthropozoonosis in Brazil. The infected animal transmits the rabies virus mainly by bites. For many years dogs and cats represented the main source of infection to humans in urban areas. Since 1973, the National Rabies Prophylaxis Program has established that dogs and cats must be immunized against rabies. The animal vaccination is safe, reliable and effective to protect animals against infectious diseases and prevent the transmission of zoonoses, however the administration of vaccines is not without risks. The occurrences of adverse events associated with vaccination should be investigated, because the demonstration of vaccine safety contributed to the success of immunization programs. This study describes a case report of one animal suspected of having an adverse reaction to rabies vaccination.

A raiva é uma antropozoonose endêmica no Brasil. O animal infectado transmite o vírus rábico principalmente através de mordeduras. Por muitos anos cães e gatos representaram a principal fonte de infecção para seres humanos em áreas urbanas. Desde o ano de 1973, o Programa Nacional de Profilaxia da Raiva estabelece que cães e gatos devem ser imunizados contra raiva. A vacinação animal é um meio seguro, confiável e eficaz para proteger animais contra doenças infecciosas e prevenir a transmissão de zoonoses, contudo a administração de vacinas não é isenta de riscos. Portanto as ocorrências de evento adverso associados à vacinação devem ser investigadas, pois a demonstração da segurança das vacinas contribuiu para o sucesso dos programas de imunização. Este estudo descreve o relato de caso de um animal suspeito de apresentar reação adversa à vacinação antirrábica.

Esporotricose: uma zoonose negligenciada / Sporotricosis: a neglected zoonosis

A esporotricose é uma zoonose causada por fungos do complexo Sporothrix spp. Esse microrganismo é saprófito e está naturalmente presente no solo, sendo contraído pelos hospedeiros a partir do contato com animais infectados, manuseio de terra e plantas. É uma doença emergente negligenciada, de impacto na saúde pública, e os felinos domésticos têm importante papel na sua propagação. Os hábitos da espécie de afiar suas garras e encobrir seus dejetos, assim como arranhaduras ou mordeduras durante brigas por território e acasalamento, favorecem a inoculação do fungo. A apresentação clínica mais frequente em animais e humanos é a cutânea, mas uma forma sistêmica pode ocorrer em pacientes imunocomprometidos. As saúdes humana, ambiental e animal estão intimamente ligadas e, para que haja bem-estar geral, é preciso que esses três pilares estejam em equilíbrio, com isso, a atuação do médico-veterinário se torna indispensável no controle de zoonoses. A criação de políticas públicas para controle e erradicação da esporotricose é fundamental para controlar a epidemia no Brasil e o médico-veterinário deve participar ativamente desse processo.

Sporotrichosis is a zoonosis caused by fungi of the Sporothirix spp complex. This microorganism is saprophytic and is naturally present in the soil, being contracted by the hosts from contact with infected animals, handling of land and plants. It is an emerging neglected disease with an impact on public health, and domestic cats play an important role in the spread of the disease. The species' habits of sharpening their claws and covering their waste, as well scratches or bites during fights over territory and mating favor the inoculation of the fungus. The most common clinical presentation in animals and humans is cutaneous, but a systemic form can occur immunocompromised patients. Environmental human and animal health are closely linked, and in order for there to be general well-being, these three pillars need to be in balance; then, the role of the veterinarian becomes indispensable in the control of zoonosis. The creation of public policies for the control and eradication of sporotrichosis is essential to control the epidemic in Brazil and the veterinarian must actively participate in this process.

Investigação de evento adverso associado à vacinação antirrábica / Investigation of adverse event following immunization associated with antirabies vaccine / Investigación del evento adverso asociado a la vacunación antirrábica

A raiva é uma antropozoonose endêmica no Brasil. O animal infectado transmite o vírus rábico principalmente através de mordeduras. Por muitos anos cães e gatos representaram a principal fonte de infecção para seres humanos em áreas urbanas. Desde o ano de 1973, o Programa Nacional de Profilaxia da Raiva estabelece que cães e gatos devem ser imunizados contra raiva. A vacinação animal é um meio seguro, confiável e eficaz para proteger animais contra doenças infecciosas e prevenir a transmissão de zoonoses, contudo a administração de vacinas não é isenta de riscos. Portanto as ocorrências de evento adverso associados à vacinação devem ser investigadas, pois a demonstração da segurança das vacinas contribuiu para o sucesso dos programas de imunização. Este estudo descreve o relato de caso de um animal suspeito de apresentar reação adversa à vacinação antirrábica.

Rabies is an endemic anthropozoonosis in Brazil. The infected animal transmits the rabies virus mainly by bites. For many years dogs and cats represented the main source of infection to humans in urban areas. Since 1973, the National Rabies Prophylaxis Program has established that dogs and cats must be immunized against rabies. The animal vaccination is safe, reliable and effective to protect animals against infectious diseases and prevent the transmission of zoonoses, however the administration of vaccines is not without risks. The occurrences of adverse events associated with vaccination should be investigated, because the demonstration of vaccine safety contributed to the success of immunization programs. This study describes a case report of one animal suspected of having an adverse reaction to rabies vaccination.

La rabia es una antropozoonosis endémica en Brasil. El animal infectado transmite el virus de la rabia principalmente a través de mordeduras. Durante muchos años, los perros y gatos representaron la principal fuente de infección para los humanos en las zonas urbanas. Desde 1973, el Programa Nacional de Profilaxis de la Rabia ha establecido que los perros y gatos deben ser inmunizados contra la rabia. La vacunación animal es una forma segura, fiable y eficaz de proteger a los animales contra enfermedades infecciosas y prevenir la transmisión de zoonosis, sin embargo, la administración de vacunas no está exenta de riesgos. Por lo tanto, se debe investigar la ocurrencia de eventos adversos asociados con la vacunación, ya que la demostración de la seguridad de la vacuna contribuyó al éxito de los programas de inmunización. Este estudio describe el reporte de un caso de un animal sospechoso de tener una reacción adversa a la vacunación antirrábica.

Serological detection of Brazilian Spotted-Fever Group Rickettsiae in horses in Brasília, Federal District, Brazil / Detecção sorológica de Rickettsiae do grupo da Febre Maculosa Brasileira em cavalos de Brasília, Distrito Federal, Brasil

Brazilian spotted fever (BSF) is a zoonosis caused by spotted-fever group Rickettsiae that is transmitted to humans through tick bites. Dogs and horses are considered to be sentinel animals for this disease. In this study, a serological survey was carried out among horses apprehended by the governmental animal control service of the Federal District, Brazil. Serum samples were obtained from 122 horses over a one-year period. Through the indirect immunofluorescence antibody assay (IFA) for Rickettsia rickettsii anti-IgG antibodies, 21 samples were found to be positive, with titers ranging from 1:64 to 1:512. This demonstrates that the agent presents silent circulation in the Federal District.

A febre maculosa brasileira (FMB) é uma zoonose causada por riquétsias do Grupo da Febre Maculosa transmitida ao homem através de picadas de carrapatos. Cães e cavalos são considerados animais sentinelas para essa doença. Neste estudo, foi realizado inquérito sorológico em cavalos apreendidos pelo serviço governamental de controle de animais do Distrito Federal, Brasil. Os soros utilizados foram obtidos de 122 cavalos, coletados por conveniência pelo período de um ano. Através do ensaio de imunofluorescência indireta (IFA) para anticorpos anti-IgG contra Rickettsia rickettsii, 21 amostras foram positivas para títulos variando de 1:64 a 1:512, demonstrando a circulação silenciosa do agente no Distrito Federal.

Prevalence of Bartonella species in shelter cats and their ectoparasites in southeastern Brazil / Prevalência de espécies de Bartonella em gatos de abrigos e seus ectoparasitas no Sudeste do Brasil

Abstract Feline Bartonella can be transmitted to humans through cat scratches or bites, and between cats, by the flea Ctenocephalides felis. The study was carried out in order to investigate the occurrence of Bartonella DNA in cats living in shelters and their ectoparasites and the relationship between the infection status of cats and ectoparasites they host. Bartonella DNA was detected in 47.8% of the cat blood samples, 18.3% of C. felis fleas, 13.3% of flea egg pools and 12.5% of lice pools. B. henselae and B. clarridgeiae DNA were detected in cat fleas, while B. henselae, B. clarridgeiae and B. koehlerae were found in blood samples from bacteremic cats. Cats infested by positive ectoparasites showed approximately twice the odds of being infected. Our results indicate that shelter cats have high prevalence of Bartonella species that are known to be human pathogens. This highlights the importance of controlling infestations by ectoparasites to avoid cat and human infection.

Resumo Algumas espécies de Bartonella têm os felinos como principais hospedeiros reservatórios. Tais patógenos são transmitidos ao homem por intermédio da arranhadura ou mordedura de gatos e entre os gatos, por meio da pulga Ctenocephalides felis. O objetivo deste estudo foi investigar a ocorrência de DNA de Bartonella spp. em gatos de abrigos e seus ectoparasitas e a relação entre o estado de infecção dos gatos e dos ectoparasitas albergados por estes. Material genético bacteriano foi detectado em 47,8% das amostras de sangue de gatos, 18,3% das pulgas C. felis, 13,3% dos "pools" de ovos de pulgas e 12,5% dos "pools" de piolhos. DNA de B. henselae e B. clarridgeiae foi detectado em pulgas, e B. henselae, B. clarridgeiae e B. koehlerae, em amostras de sangue de gatos. Gatos infestados por ectoparasitas que carreavam DNA de Bartonella spp. demonstraram aproximadamente o dobro de chance de estarem infectados. Esses resultados indicam que os gatos de abrigos têm alta prevalência de infecção por espécies de Bartonella, capazes de causar doenças no homem. E também destacam a importância do controle e prevenção da infestação por ectoparasitas, no intuito de prevenir a infecção em gatos e humanos.

Human post exposure anti-rabies prophylactic assistance in the south of Brazil / Assistência profilática anti-rábica pós-exposição humana no sul do Brasil

Rabies is a zoonosis caused by Lyssavirus, with progressive development and a high lethality rate. In Brazil, rabies and accidents caused by animals potentially transmitting the disease are mandatory notification injuries. Exposure to rabies infection places a high financial burden on public health systems, especially for the care of people who are exposed and have a high risk of death. We aimed to define the epidemiological profile of human rabies post-exposure assistance in the municipality of Santa Maria, Rio Grande do Sul, Brazil, from 2010 to 2015. Data from Brazil's Notifiable Diseases Information System were obtained and analyzed; these data were acquired by the completion of individual inquiry forms querying human antirabies assistance. A total of 55% (1,898/3,453) of anti-rabies assistance cases involved women and 45%(1,555/3,453) men. The highest occurrence (54.5%-1,882/3,453) was in the age group of 20–59 years. Most registered cases (87.5%–3,024/3.453) were caused by dogs, followed by cats (10.9%–378/3,453). The lower limb (22.1%–617/2,790) was the area of the body with the highest number of canine bites. We observed incorrect indications for the treatment. We suggest further training for health professionals involved in rabies post-exposure prophylaxis care, and dissemination of information aimed at educating users about the importance of animal-related injuries.

A raiva é uma zoonose causada por Lyssavirus, com desenvolvimento progressivo e alta taxa de letalidade. No Brasil, a raiva e os acidentes causados por animais potencialmente transmissores da doença, são agravos de notificação obrigatória. A exposição à infecção por raiva coloca um alto ônus financeiro para o sistema público de saúde, especialmente para o atendimento de pessoas expostas e com alto risco de morte. O objetivo deste estudo foi definir o perfil epidemiológico da assistência pós-exposição à raiva humana no município de Santa Maria, Rio Grande do Sul, Brasil, de 2010 a 2015. Foram obtidos e analisados os dados do Sistema de Informações sobre Doenças Notificáveis do Brasil (SINAM); adquiridos por meio do preenchimento de formulários de consulta individuais, verificando a assistência antirrábica humana. Um total de 55% (1.898/3.453) e 45% (1.555/3.453) dos casos de assistência anti-rábica envolveu mulheres e homens respectivamente, com maior ocorrência na faixa etária de 20 a 59 anos (54,5% - 1.882/3.453). A maioria dos casos registrados (87,5% - 3.024/3.453) foi causada por cães e 10,9% (378/3.453) por gatos. O membro inferior (22,1% - 617/2.790) foi a área do corpo com o maior número de agressões por cães. Desta forma, sugere-se o treinamento para profissionais de saúde envolvidos no tratamento profilático da raiva após a exposição e disseminação de informações destinadas a educar os usuários sobre a importância das lesões relacionadas a animais.

Caseous stomatitis caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be anopportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganismmay present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reportsof infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agentsinvolved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amaral’s boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspectin the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination,and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of theisolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolatedand showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaningof the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine.Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole...

Human post exposure anti-rabies prophylactic assistance in the south of Brazil / Assistência profilática anti-rábica pós-exposição humana no sul do Brasil

Rabies is a zoonosis caused by Lyssavirus, with progressive development and a high lethality rate. In Brazil, rabies and accidents caused by animals potentially transmitting the disease are mandatory notification injuries. Exposure to rabies infection places a high financial burden on public health systems, especially for the care of people who are exposed and have a high risk of death. We aimed to define the epidemiological profile of human rabies post-exposure assistance in the municipality of Santa Maria, Rio Grande do Sul, Brazil, from 2010 to 2015. Data from Brazil's Notifiable Diseases Information System were obtained and analyzed; these data were acquired by the completion of individual inquiry forms querying human antirabies assistance. A total of 55% (1,898/3,453) of anti-rabies assistance cases involved women and 45%(1,555/3,453) men. The highest occurrence (54.5%-1,882/3,453) was in the age group of 20–59 years. Most registered cases (87.5%–3,024/3.453) were caused by dogs, followed by cats (10.9%–378/3,453). The lower limb (22.1%–617/2,790) was the area of the body with the highest number of canine bites. We observed incorrect indications for the treatment. We suggest further training for health professionals involved in rabies post-exposure prophylaxis care, and dissemination of information aimed at educating users about the importance of animal-related injuries.(AU)

A raiva é uma zoonose causada por Lyssavirus, com desenvolvimento progressivo e alta taxa de letalidade. No Brasil, a raiva e os acidentes causados por animais potencialmente transmissores da doença, são agravos de notificação obrigatória. A exposição à infecção por raiva coloca um alto ônus financeiro para o sistema público de saúde, especialmente para o atendimento de pessoas expostas e com alto risco de morte. O objetivo deste estudo foi definir o perfil epidemiológico da assistência pós-exposição à raiva humana no município de Santa Maria, Rio Grande do Sul, Brasil, de 2010 a 2015. Foram obtidos e analisados os dados do Sistema de Informações sobre Doenças Notificáveis do Brasil (SINAM); adquiridos por meio do preenchimento de formulários de consulta individuais, verificando a assistência antirrábica humana. Um total de 55% (1.898/3.453) e 45% (1.555/3.453) dos casos de assistência anti-rábica envolveu mulheres e homens respectivamente, com maior ocorrência na faixa etária de 20 a 59 anos (54,5% - 1.882/3.453). A maioria dos casos registrados (87,5% - 3.024/3.453) foi causada por cães e 10,9% (378/3.453) por gatos. O membro inferior (22,1% - 617/2.790) foi a área do corpo com o maior número de agressões por cães. Desta forma, sugere-se o treinamento para profissionais de saúde envolvidos no tratamento profilático da raiva após a exposição e disseminação de informações destinadas a educar os usuários sobre a importância das lesões relacionadas a animais.(AU)

Caseous stomatitis caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be anopportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganismmay present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reportsof infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agentsinvolved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amarals boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspectin the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination,and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of theisolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolatedand showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaningof the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine.Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole...(AU)

Acute renal failure in a horse following bee sting toxicity / Insuficiência renal aguda associada à intoxicação por picadas de abelhas em um cavalo

Bee envenomation is frequent in humans and dogs, but uncommon in horses. This study aimed to describe a case of acute renal failure following mass envenomation in a horse. A mare was attacked by a swarm of bees and showed reluctance to move, epistaxis, and dark-brown urine. Biochemical exams revealed increase in urea and creatine serum levels. The mare did not respond to treatment and euthanasia was elected after four days of clinical course. At the necropsy, there were multifocal pinpoint to elevated skin lesions associated with edema and hemorrhage, which extended to the subcutaneous tissue and skeletal muscle, and the kidneys were diffusely dark-brown and friable. Microscopically, renal tubules were distended and filled with an orange-red, hyaline globular material, and had severe epithelial tubular cell necrosis. The diagnosis was established based on clinical and histological analysis, and pathological evaluation was essential to confirm acute renal failure due to bee sting toxicity.(AU)

Acidentes por picada de abelhas são frequentemente descritos em humanos e cães, entretanto relatos em cavalos são escassos. Este trabalho teve como objetivo descrever um caso de insuficiência renal aguda em um equino após múltiplas picadas de abelhas. Uma égua foi atacada por um enxame de abelhas desenvolvendo quadro clínico de relutância em se movimentar, epistaxe e urina marrom-escura. Exames bioquímicos demonstraram aumento nos níveis séricos de ureia e creatina. O equino não respondeu ao tratamento e a eutanásia foi realizada após quatro dias de curso clínico. Na necropsia havia múltiplas elevações cutâneas, que ao corte exibiam edema e hemorragia, os quais se estendiam ao subcutâneo e musculatura adjacente. Os rins estavam difusamente marrom-escuros e havia friáveis. Microscopicamente, os túbulos renais estavam distendidos e preenchidos por um material hialino, globular, laranja-avermelhado e havia acentuada necrose das células epiteliais tubulares. O diagnóstico foi obtido por meio da análise clínica e histológica, e a avaliação patológica foi essencial para confirmar a insuficiência renal aguda por picada de abelha.(AU)

Use of phytotherapics, low power laser and ozone for biting wound in dog

Background: Skin wounds are among the most common cases in small animals, highlighting the importance of alternativetherapies as an aid to the healing process. These include ozone, which has a bactericidal and immunomodulatory action; thelow power laser that determines photodynamic changes triggering metabolism elevation; and the use of medicinal plants,in which several herbal medicines has been mentioned in research relating their benefits to wound healing in humans andanimals. Thus, it aims to report the case of a dog submitted to these treatments due to chronic wound due to bite.Case: A 6-year-old canine, female, mixed-breed, 8 kg, with a perforating wound in the left anterior limb in the scapularand humeral region, caused by trauma from the bite of another dog, previously treated, without clinical improvement,has been attended presenting apathy, increased body temperature (40.1°C), difficulty in walking and inability to supportthe injured limb, which was swollen, hyperemic, with elevated temperature, absence of hair, elevated pain sensitivity andpresence of 2 circular lesions, approximately 2 cm in diameter, caused by trauma, and others of size between 0.5 and 1 cmin diameter, which appeared during the course of the disease, characterized as fistulas, through which there was drainageof characteristic fluid exudative and purulent discharge. It was collected blood sample for blood count and purulent material through sterile swab for culture and antibiogram. Systemic treatment with ceftiofur, dipyrone, meloxican and topicalcleaning of the wounds with hydrogen peroxide and physiological solution; dimethyl sulfoxide ointment, and hot compresses was chosen. After seven days, the animal showed significant general clinical...

Use of phytotherapics, low power laser and ozone for biting wound in dog

Background: Skin wounds are among the most common cases in small animals, highlighting the importance of alternativetherapies as an aid to the healing process. These include ozone, which has a bactericidal and immunomodulatory action; thelow power laser that determines photodynamic changes triggering metabolism elevation; and the use of medicinal plants,in which several herbal medicines has been mentioned in research relating their benefits to wound healing in humans andanimals. Thus, it aims to report the case of a dog submitted to these treatments due to chronic wound due to bite.Case: A 6-year-old canine, female, mixed-breed, 8 kg, with a perforating wound in the left anterior limb in the scapularand humeral region, caused by trauma from the bite of another dog, previously treated, without clinical improvement,has been attended presenting apathy, increased body temperature (40.1°C), difficulty in walking and inability to supportthe injured limb, which was swollen, hyperemic, with elevated temperature, absence of hair, elevated pain sensitivity andpresence of 2 circular lesions, approximately 2 cm in diameter, caused by trauma, and others of size between 0.5 and 1 cmin diameter, which appeared during the course of the disease, characterized as fistulas, through which there was drainageof characteristic fluid exudative and purulent discharge. It was collected blood sample for blood count and purulent material through sterile swab for culture and antibiogram. Systemic treatment with ceftiofur, dipyrone, meloxican and topicalcleaning of the wounds with hydrogen peroxide and physiological solution; dimethyl sulfoxide ointment, and hot compresses was chosen. After seven days, the animal showed significant general clinical...(AU)

Scorpion stings in pregnancy: an analysis of outcomes in 66 envenomed pregnant patients in Iran

Scorpionism is one of the most important health problems in tropical regions, which unfortunately results in thousands of deaths annually. Pregnant women are potential victims in areas with high scorpion-sting prevalence. Limited medical data are available on the effects of scorpion envenomation in pregnant women. This study aimed to examine the effect of scorpion envenomation on pregnancy outcomes in 66 cases. Methods: The present descriptive/analytical cross-sectional study was performed on 66 scorpion-envenomed pregnant women referred to the clinical toxicology unit of Ahvaz Razi Hospital in Iran during 2015-2017. The variables assessed in all cases, via questionnaire and hospital medical records, were: age, patient residency, gestational week, status of the fetus, laboratory anomalies, clinical severity of envenomation, sting site and scorpion species. Pregnancy outcome (miscarriage, stillbirth, preterm birth, normal delivery) and status of the newborns were also evaluated. Data were analyzed using SPSS ® software (version 24.0). Results: The following pregnancy outcomes were recorded from envenomed pregnant women: miscarriage = 1.5% (n = 1), stillbirth = 4.5% (n = 3), preterm birth = 10.6% (n = 7), normal birth = 83% (n = 55). Among participants whose pregnancy led to birth, 11(17.7%) cases had prenatal-neonatal complications. Neonatal complications, including Apgar score less than 8 points at 5 min, were found in 7 (11.3%) preterm birth cases and in 4 (6.4%) normal birth cases, along with birth weight below 2500 g in normal births. A significant relationship was found between adverse pregnancy outcomes and bite location, as well as scorpion species, but no relationship was found with other variables. Conclusion: Envenomation significantly contributes to preterm birth. Moreover, the location of bites and the type of scorpion species have a decisive role in the pregnancy outcome of scorpion-envenomed pregnant women.(AU)

Epidemiological and clinical aspects of snakebites in the upper Juruá River region, western Brazilian Amazonia / Aspectos clínicos e epidemiológicos de acidentes ofídicos na região do Alto Juruá, oeste da Amazônia brasileira

This study addresses the clinical and epidemiological aspects of envenoming cases resulting from snakebites treated at a hospital in Cruzeiro do Sul, in the upper Juruá River region, western Brazilian Amazonia. The specific identity of snakes that caused the envenomings was inferred (a) from the diagnosis of patient symptoms and signs upon hospital admission, (b) by enzyme immunoassay for detection of Bothrops atrox and Lachesis muta venom from serum samples taken from patients before antivenom therapy, or (c) by direct identification of the snake, when it was brought along to the hospital or photographed. There were 133 snakebites (76.2 cases per 100,000 inhabitants) registered during one year (July 2017 to June 2018). Most snakebites (88.7%) were caused by Bothrops spp., and the rest by non-venomous snakes or dry bites. Snakebites tended to occur more often during the rainy season, coinciding with the period of greater reproductive activity of the snakes and greater availability of their prey. In addition, the increase in the water level of rivers and lakes during the rainy season tends to concentrate snakes in dry places and, thus, to increase encounters with humans. Information campaigns on prevention and first aid, specially among the most vulnerable groups (indigenous people, farmers, and children and teenagers in rural areas), and the importance of using protective equipment (boots, leggings, leather gloves) in certain high risk activities (e.g. agriculture and extractivism in forests) are fundamental for the reduction of snakebite morbidity.(AU)

Este estudo aborda os aspectos clínicos e epidemiológicos dos envenenamentos ofídicos tratados em um hospital em Cruzeiro do Sul, Acre, resultantes de acidentes que ocorreram na região do Alto Juruá, no oeste da Amazônia brasileira. A identidade específica das serpentes que causaram os envenenamentos foi inferida (a) pelos sinais e sintomas apresentados pelo paciente na admissão hospitalar, (b) por imunoensaio enzimático para detecção de veneno de Bothrops atrox e Lachesis muta em amostras de soro retiradas de pacientes antes da soroterapia, e (c) pela identificação direta da serpente, quando esta foi levada para o hospital ou fotografada. Houve 133 casos (76,2 casos por 100.000 habitantes) de acidentes ofídicos registrados durante um ano (julho 2017 a junho 2018). A maioria das picadas de serpentes (88,7%) foi causada por Bothrops spp., e o restante por espécies não peçonhentas ou picadas secas. Os acidentes ofídicos tenderam a ocorrer com maior frequência durante a estação chuvosa, coincidindo com o período de maior atividade reprodutiva das serpentes e maior disponibilidade de suas presas. Além disso, o aumento dos níveis de rios e lagos pode fazer com que esses animais procurem locais mais secos, aumentando a frequência de encontro com seres humanos. Campanhas educativas sobre prevenção e primeiros socorros, principalmente entre os grupos mais vulneráveis (indígenas, agricultores, crianças e adolescentes em áreas rurais), e sobre a importância da utilização de equipamentos de proteção (botas, perneiras, luvas de couro) em determinadas atividades de maior risco (e.g., agricultura e extrativismo em florestas), são fundamentais para reduzir a morbidade de picadas de serpentes.(AU)

Scorpion stings in pregnancy: an analysis of outcomes in 66 envenomed pregnant patients in Iran

Background: Scorpionism is one of the most important health problems in tropical regions, which unfortunately results in thousands of deaths annually. Pregnant women are potential victims in areas with high scorpion-sting prevalence. Limited medical data are available on the effects of scorpion envenomation in pregnant women. This study aimed to examine the effect of scorpion envenomation on pregnancy outcomes in 66 cases. Methods: The present descriptive/analytical cross-sectional study was performed on 66 scorpion-envenomed pregnant women referred to the clinical toxicology unit of Ahvaz Razi Hospital in Iran during 2015-2017. The variables assessed in all cases, via questionnaire and hospital medical records, were: age, patient residency, gestational week, status of the fetus, laboratory anomalies, clinical severity of envenomation, sting site and scorpion species. Pregnancy outcome (miscarriage, stillbirth, preterm birth, normal delivery) and status of the newborns were also evaluated. Data were analyzed using SPSS ® software (version 24.0). Results: The following pregnancy outcomes were recorded from envenomed pregnant women: miscarriage = 1.5% (n = 1), stillbirth = 4.5% (n = 3), preterm birth = 10.6% (n = 7), normal birth = 83% (n = 55). Among participants whose pregnancy led to birth, 11(17.7%) cases had prenatal-neonatal complications. Neonatal complications, including Apgar score less than 8 points at 5 min, were found in 7 (11.3%) preterm birth cases and in 4 (6.4%) normal birth cases, along with birth weight below 2500 g in normal births. A significant relationship was found between adverse pregnancy outcomes and bite location, as well as scorpion species, but no relationship was found with other variables. Conclusion: Envenomation significantly contributes to preterm birth. Moreover, the location of bites and the type of scorpion species have a decisive role in the pregnancy outcome of scorpion-envenomed pregnant women.(AU)

Detecção de anticorpos anti-Rickettsia rickettsii em cães residentes em área negligenciada no município de São Paulo, SP, Brasil / [Detection of anti-Rickettsia rickettsii antibodies in dogs living in a neglected area in São Paulo, SP, Brazil]

A febre maculosa brasileira (FMB), descrita inicialmente nos Estados Unidos como febre maculosa das Montanhas Rochosas, é uma antropozoonose relatada apenas no continente americano e causada pela bactéria Rickettsia rickettsii. No Brasil a transmissão ocorre sobretudo pela picada de carrapatos do gênero Amblyomma spp. A doença foi inicialmente descrita como de transmissão em áreas rurais e silvestres, no entanto áreas periurbanas e urbanas vêm apresentando casos, principalmente relacionados com a presença de humanos residindo em pequenos fragmentos de mata ciliar. O presente estudo teve por objetivo elucidar a dispersão da FMB nas proximidades dos reservatórios Guarapiranga e Billings, na cidade de São Paulo, SP. Para tanto, a presença de anticorpos anti-R. rickettsii, Rickettsia parkeri e Rickettsia bellii foi avaliada em cães atendidos nas campanhas de esterilização cirúrgica e residentes ao redor dos reservatórios. Foram coletadas amostras de 393 cães, e as amostras de soro foram analisadas pela reação de imunofluorescência indireta (RIFI), com ponto de corte de 1:64. Os títulos para R. rickettsii variaram de 256 a 4096, com positividade de 3,3% (13/393); para R. bellii, de 128 a 1024 e 4,1% (16/393) de positivos, e um único animal (0,25%) foi soropositivo para R. parkeri, com título de 128. Os achados permitem concluir que a região de estudo apresenta condições de se tornar uma possível área com casos de FMB, pois comporta fragmentação de Mata Atlântica, condições essas ideais para a manutenção do vetor do gênero Amblyomma já descrito na região, bem como para a presença da Rickettsia rickettsii circulante entre os cães, confirmada pela existência de anticorpos. Condutas referentes à conscientização da população por meio de trabalhos educacionais devem ser implantadas para a prevenção da doença na população da área.(AU)

Brazilian Spotted Fever (BSF), initially described in the United States as Rocky Mountain Spotted Fever, is an anthropozoonosis reported only in the Americas and caused by the bacterium Rickettsia rickettsii. In Brazil, transmission occurs mainly through tick bites of the genus Amblyomma spp. The disease was initially described as transmission of rural and wild areas; however, peri-urban and urban areas have been presenting cases, mainly related to the presence of humans residing in small fragments of riparian forest. The present study aimed to elucidate the dispersal of BSF near the Guarapiranga and Billings Reservoirs, in the city of São Paulo, SP. The presence of anti-R. rickettsii, Rickettsia parkeri and Rickettsia bellii antibodies were evaluated in dogs treated in surgical sterilization campaigns and residents around the Reservoirs. Samples were collected from 393 dogs and serum samples were analyzed by indirect immunofluorescence reaction (RIFI) with a cutoff of 1:64. The titles for R. rickettsii varied from 256 to 4096 with a positivity of 3.3% (13/393); for R. bellii from 128 to 1024 and 4.1% (16/393) of positive and a single animal (0.25%) was seropositive for R. parkeri with a titre of 128. The findings allow us to conclude that the study region has conditions to become a possible area with BSF cases, as it involves Atlantic Forest, ideal conditions for the maintenance of the vector of the genus Amblyomma already described in the region and the presence of circulating Rickettsia rickettsii among dogs, confirmed by the presence of antibodies. Conducts regarding the awareness of the population through educational work should be implemented to prevent the disease in the population of the area.(AU)

Acidentes botrópicos em cães / Bothrops snakebites in dogs

Background: Snakebites occur frequently among humans and animals. In Brazil, about 23,000 cases of snakebite involving humans were recorded in 2016, 11% of them caused by venomous snakes. In the region of Cuiabá, capital of MatoGrosso, the highest occurrence is of snakes of the genus Bothrops (81%), followed by Crotalus (4%). Bothrops venom hasproteolytic, coagulant, and hemorrhagic effects, whereas Crotalus venom is neurotoxic, myotoxic and nephrotoxic. Thispaper reports on three cases of Bothrops snakebites in dogs treated at the Veterinary Hospital of the Federal Universityof Mato Grosso in 2017.Cases: Three dogs were treated showing clinical signs of snakebite, possibly by Bothrops, since their owners reportedthat these are the snakes most frequently found where they live. This information is consistent with the known geographicdistribution of snakes of the genus Bothrops in the state of Mato Grosso, Brazil. In the first report (Case 11), the patientwas bitten on two different occasions in a five-month interval, and died presumably due to anaphylactic shock causedby the venom injected by a second snakebite (Case 12). In both episodes, the animal presented a swollen face and neck,dyspnea and eye bleeding, and these signs were more severe in the second episode. Case 2 was a dog with severe neckand chest swelling and pain. The owner of this dog reported that he had taken his dog for a walk in the countryside, alongwith the dog of Case 1, and had returned home with both dogs about three hours before the consultation. Case 3 was aRottweiler living at a small family farm located 67 km from Cuiabá. The animal presented slight swelling and pain in theleft forelimb, and puncture wounds on the lower limb. Neutrophilic leukocytosis was observed in cases 1 and 3. In addition, Case 12 (the second episode of Case 1) presented thrombocytopenia and increased prothrombin time and activatedpartial...

Acidentes botrópicos em cães / Bothrops snakebites in dogs

Background: Snakebites occur frequently among humans and animals. In Brazil, about 23,000 cases of snakebite involving humans were recorded in 2016, 11% of them caused by venomous snakes. In the region of Cuiabá, capital of MatoGrosso, the highest occurrence is of snakes of the genus Bothrops (81%), followed by Crotalus (4%). Bothrops venom hasproteolytic, coagulant, and hemorrhagic effects, whereas Crotalus venom is neurotoxic, myotoxic and nephrotoxic. Thispaper reports on three cases of Bothrops snakebites in dogs treated at the Veterinary Hospital of the Federal Universityof Mato Grosso in 2017.Cases: Three dogs were treated showing clinical signs of snakebite, possibly by Bothrops, since their owners reportedthat these are the snakes most frequently found where they live. This information is consistent with the known geographicdistribution of snakes of the genus Bothrops in the state of Mato Grosso, Brazil. In the first report (Case 11), the patientwas bitten on two different occasions in a five-month interval, and died presumably due to anaphylactic shock causedby the venom injected by a second snakebite (Case 12). In both episodes, the animal presented a swollen face and neck,dyspnea and eye bleeding, and these signs were more severe in the second episode. Case 2 was a dog with severe neckand chest swelling and pain. The owner of this dog reported that he had taken his dog for a walk in the countryside, alongwith the dog of Case 1, and had returned home with both dogs about three hours before the consultation. Case 3 was aRottweiler living at a small family farm located 67 km from Cuiabá. The animal presented slight swelling and pain in theleft forelimb, and puncture wounds on the lower limb. Neutrophilic leukocytosis was observed in cases 1 and 3. In addition, Case 12 (the second episode of Case 1) presented thrombocytopenia and increased prothrombin time and activatedpartial...(AU)