CLINICAL AND PARACLINICAL CHARACTERISTICS AND EVALUATION OF TREATMENT OUTCOMES IN PATIENTS WITH PIT VIPER BITES AT MILITARY HOSPITAL 175

Abstract

Objective: To describe the clinical and paraclinical characteristics and to evaluate the treatment outcomes of patients with pit viper envenomation treated at the A25 department, Military Hospital 175.

Subjects and methods: A prospective descriptive study of a case series was conducted on 38 patients with pit viper envenomation treated at the A25 department from January to December 2023.

Results: The majority of patients were male (60.5%), with a median age of 44.7 (Q1-Q3: 29,5-60,2). Accidents occurred mainly in the rainy season (82.5%) and in the evening (57.9%). The red-tailed pit viper (Trimeresurus albolabris) was the primary agent (81.6%). Common clinical symptoms included moderate pain (60.5%), local swelling (36.8% localized; 34.2% extensive >50 cm), and bruising (84.2%). The 20-minute whole blood clotting test was positive in 97.4% of patients. Coagulopathy was characterized by decreased fibrinogen (26.3% at admission). Most patients (94.8%) were of moderate severity, with no severe cases. 89.5% of patients received specific snake antivenom (SAV), mostly requiring only one dose (67.6%). After 48 hours of treatment, 100% of patients reported significant pain reduction. The cure rate reached 94.8%, with an average hospital stay of 4.5 days. Fibrinogen levels showed a statistically significant negative correlation with the extent of swelling (p=0.002).

Conclusion: Pit viper envenomation occurs predominantly during the rainy season and causes local tissue injury accompanied by coagulopathy. Snake antivenom therapy is highly effective.