Ofidismo: Actualización en el diagnóstico, manejo y tratamiento

Abstract

Venomous animals are considered one of the world's neglected diseases. Globally, it is estimated that between 1.8and 2.7 million cases of snakebite envenomation occur annually, with a mortality rate ranging from 81,000 to 138,000deaths. These incidents occur in low-income countries in Asia, Africa, and Latin America. In our country, the mainvenomous snake species that attack humans are Bothrops atrox (predominant in the Amazon) and primarily responsiblefor more than 95% of accidents, followed by Bothrops bilineatus (“loro machaco”), Bothrops pictus (“jergón de la costa”),Crotalus durissus terrificus (“cascabe” or “rattlesnake”), and Lachesis muta (“shushupe”). Snakes of the genus Micrurus(“naca naca”) are also common. This comprehensive review will present the main epidemiological, clinical,pathophysiological, therapeutic, and preventative characteristics at all levels of healthcare. The most effective treatmentremains the use of antivenom, administered according to the severity of the bite. A few decades ago, antivenom was onlyadministered within the first 24 hours; however, due to improved scientific understanding of snakebites, antivenom cannow be administered for up to three days or more. In the past, folk remedies were used, such as Incisions, ligatures,tourniquets, etc., only worsen and complicate management. The best specific therapy is antivenom for the specific snake.