Systemic Complications occurring after Korean Venomous Snake Bite, with focus on Hematologic and Neurologic Complications

Park, Eun Jung; Yoon, Sang Kyu; Ahn, Jung Hwan; Choi, Sang Cheon; Kim, Gi Woon; Min, Young Gi; Lee, Kuk Jong; Jung, Ho Sung; Jung, Yoon Seok

Abstract

PURPOSE: This study explored and evaluated the systemic complications resulting from the bite of Korean venomous snake, focussing on hematologic and neurologic features.
METHODS
Medical records (demographic data, clinical measurements including laboratory results, severity score, and amount of antidote administration, and hospitalization course) of consecutive patients who presented with snakebites to two university teaching hospital during a 10-year period were retrospectively reviewed. Subgroup analysis was conducted for evaluations of anti-acetylcholine esterase administration in complicated victims.
RESULTS
The 170 patients displayed occurrence rates of hematologic and neurologic complications of 12.9% and 20.6%, respectively. Among 22 patients with hematologic complications, isolated thrombocytopenia was evident in eight patients (36.4%), prothrombin time (PT)/activated partial thromboplastin time (aPTT) prolongation in 11 patients (50.0%), and both in three patients (13.6%). The mean time to recovery was 4.5+/-1.8 days for isolated thrombocytopenia, and 5.1+/-1.8 days for PT and aPTT prolongation. Hematologic complications could occur suddenly 1~4 days after hospitalization. Among 35 patients with neurologic complications, dizziness was evident in 16 patients (45.7%), and diplopia / blurred vision in 19 patients (54.3%). The mean time to recovery was 3.4+/-0.6 days in patients receiving anti-acetylcholine esterase and 6.9+/-1.8 days in those not receiving anti-acetylcholine esterase (p=0.00).
CONCLUSION
Occurrence rates of hematologic and neurologic complications following venomous snake bite differed as compared to other studies conducted in Korea. Onset of hematologic complications can occur rapidly days after admittance. Anti-acetylcholine esterase administration may be effective in treating neurologic complications.