- Trauma
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Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study
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Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin
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Acute Crit Care. 2019;34(4):269-275. Published online November 18, 2019
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DOI: https://doi.org/10.4266/acc.2019.00591
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Correction in: Acute Crit Care 2020;35(1):56
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5,103
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8
Web of Science
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 Abstract
 PDF
- Background
Snakebite can cause various complications, including coagulopathy. The clinical features of snakebite-associated coagulopathy differ from those of disseminated intravascular coagulation (DIC) caused by other diseases and its treatment is controversial.
Methods
We retrospectively reviewed the medical records of patients hospitalized for snakebite between January 2006 and September 2018.
Results
A total of 226 patients were hospitalized due to snakebite. Their median hospital stay was 4.0 days (interquartile range, 2.0 to 7.0 days). Five patients arrived at hospital with shock and one patient died. Twenty-one patients had overt DIC according to the International Society of Thrombosis and Hemostasis scoring system. Two patients developed major bleeding complications. Initial lower cholesterol level at presentation was associated with the development of overt DIC. International normalization ratio (INR) exceeding the laboratory’s measurement limit was recorded as late as 4 to 5 days after the bite. Higher antivenom doses (≥18,000 units) and transfusion of fresh frozen plasma (FFP) or cryoprecipitate did not affect prolonged INR duration or hospital stay in the overt DIC patients without bleeding.
Conclusions
Initial lower cholesterol level may be a risk factor for overt DIC following snakebite. Although patients lack apparent symptoms, the risk of coagulopathy should be assessed for at least 4 to 5 days following snakebite. Higher antivenom doses and transfusion of FFP or cryoprecipitate may be unbeneficial for coagulopathic patients without bleeding.
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Citations
Citations to this article as recorded by  - A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study
Maya Gopalakrishnan, Suman Saurabh, Pramod Sagar, Chanaveerappa Bammigatti, Tarun Kumar Dutta, Nicholas R. Casewell
PLOS Neglected Tropical Diseases.2022; 16(2): e0010183. CrossRef - Attempt for a Recombinant Thrombomodulin Alpha Treatment in a Rat Disseminated Intravascular Coagulation Model Using Yamakagashi (Rhabdophis tigrinus) Venom
Akihiko Yamamoto, Takashi Ito, Toru Hifumi
Toxins.2022; 14(5): 322. CrossRef - Coagulopathy following Crotaliπae snakebites in northeast Florida
Satish Maharaj, Karan Seegobin, Simone Chang
Blood Coagulation & Fibrinolysis.2022; 33(4): 220. CrossRef - Unmasking the ties of snake bite poisoning and COVID-19
Anjuman Chander, Tanvir Samra, Sekar Loganathan, Varun Mahajan
Ain-Shams Journal of Anesthesiology.2022;[Epub] CrossRef - Venom induced consumption coagulopathy and performance of 20-min whole blood clotting test for its detection in viperid envenomation
Bayye Rajkumar, Kolar Vishwanath Vinod, Rakhee Kar, Premkumar Ramasubramani
Journal of the Royal College of Physicians of Edinburgh.2022; 52(3): 232. CrossRef - The effect of myocardial injury on the clinical course of snake envenomation in South Korea
J. M. Moon, Y. J. Koo, B. J. Chun, K. H. Park, Y. S. Cho, J. C. Kim, S. D. Lee, Y. R. Min, H. S. Park
Clinical Toxicology.2021; 59(4): 286. CrossRef
- Infection
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Experience with Elizabethkingia meningoseptica Infection in Adult Patients at a Tertiary Hospital
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Hyun Don Joo, Sun Young Ann, Sung Hyeok Ryou, Youn Seup Kim, Jong Wan Kim, Doh Hyung Kim
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Korean J Crit Care Med. 2015;30(4):241-248. Published online November 30, 2015
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DOI: https://doi.org/10.4266/kjccm.2015.30.4.241
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9,419
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1
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Abstract
PDF
- Background
Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection.
Methods
Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed.
Results
E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3–9] vs. 4 [range, 0–9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics.
Conclusions
E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
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Citations
Citations to this article as recorded by - Elizabethkingia meningosepticum Isolated from Pleural Fluid: A Diagnostic Dilemma
Abha Sharma, Shweta Gupta, Tanisha Bharara, Shalini Dewan Duggal, Pragnya Paramita Jena, Renu Gur
The Indian Journal of Chest Diseases and Allied Sciences.2022; 61(2): 91. CrossRef
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