Bites by the colubrid snake Philodryas patagoniensis A clinicaland epidemiological study of 297 cases

ABSTRACT

We retrospectively analyzed 297 proven cases of Philodryas patagoniensis bites admitted to Hospital Vital Brazil (HVB), Butantan Institute, São Paulo, Brazil, between 1959 and 2008.Only cases in which the causative animal was brought and identified were included. Part of the snakes brought by the patients was still preserved in the collection maintained by theLaboratory of Herpetology. Of the 297 cases, in 199 it was possible to describe the gender of the snake, and seventy three (61.3%) of them were female. The length of snakes (snoutventlength) ranged from 160 to 1080 mm. In 117 snakes their state of preservationenabled the dissection and examination of their stomach contents. The stomach wasempty in 106 snakes (89.1%). Most bites occurred in the seasons of spring and summer (n » 196, 66.0%) and during warmer periods of the day. The mean age of the victims was 24.1 15.1 years old and 206 (69.4%) patients were men. Around 92% of the patientssought medical care within 6 h after the bite. Both lower (n » 188, 63.3%) and upper limbs (n » 102, 34.3%) were most frequently bitten, especially the feet and hands (n » 205, 69.0%). The local clinical manifestations were pain (n » 151, 50.8%), transitory bleeding (n » 106, 35.7%), erythema (n » 47, 15.8%) and edema (n » 39, 13.1%). Ecchymosis was not observed. Only 7 (2.4%) patients reported systemic symptoms...