A CASE OF NEGLECTED SNAKEBITE COMPLICATED BY NECROTIZING FASCIITIS AND LOWER LIMB AMPUTATION

O. Elserafy, Nada Abdel-raof
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Abstract

Background: Snakebite is considered an underreported health issue in the rural areas of the 3 rd world countries that was recently recognized by the world health organization as a neglected tropical disease. Case presentation: In the following case study, we are discussing a case of a female patient who was bitten by an unidentified snake where she sought non-specialized medical advice who prescribed non-specific management. Moreover, a traditional local snakebite therapist performed multiple local incisions. The condition was complicated by the development of necrotizing fasciitis in her right foot that ascended to the level of the thigh. Surgical consultation was done where the patient received Rocephin 2g\24H and Tavanic 500mg/24h in addition to surgical debridement of the necrotic tissue. However, below-hip limb amputation was performed as a salvage procedure for the patient life. Conclusion: the early administration of antivenom could prevent the development of complications by neutralizing the effect of the venom. This could be achieved through providing training to primary health care physicians working in rural and remote areas on the proper management of snakebites. In addition, it is essential to ensure a sufficient supply and proper storage of the antivenom in those areas.
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被忽视的蛇咬伤并发坏死性筋膜炎及下肢截肢1例
背景:蛇咬伤被认为是第三世界国家农村地区报告不足的健康问题,最近被世界卫生组织确认为被忽视的热带病。案例介绍:在下面的案例研究中,我们正在讨论一个被不明蛇咬伤的女性患者,她在那里寻求非专业的医疗建议,医生开出了非特定的治疗方法。此外,传统的当地蛇咬伤治疗师进行了多个局部切口。右脚坏死性筋膜炎的发展使病情复杂化,并上升到大腿的水平。手术会诊时,患者接受Rocephin 2g\24H和Tavanic 500mg/ 24H,并对坏死组织进行手术清创。然而,髋部以下肢体截肢是为了挽救病人的生命而进行的。结论:早期给予抗蛇毒血清可以中和其作用,防止并发症的发生。这可以通过向在农村和偏远地区工作的初级保健医生提供适当管理蛇咬伤的培训来实现。此外,必须确保这些地区的抗蛇毒血清有足够的供应和适当的储存。
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