Venom induced pressure elevation reversible syndrome: a severe pediatric rattlesnake envenomation, evidence for conservative management, and call for naming the syndromeVenom induced pressure elevation reversible syndrome: a severe pediatric rattlesnake envenomation, evidence for conservative management, and call for naming the syndrome

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  Venom induced pressure elevation reversible syndrome: a severe pediatric rattlesnake envenomation, evidence for conservative management, and call for naming the syndromeVenom induced pressure elevation reversible syndrome: a severe pediatric rattlesnake envenomation, evidence for conservative management, and call for naming the syndrome Abstract Introduction : Rattlesnake envenomation frequently mimics traumatic compartment syndrome, as both are characterized by severe pain, swelling, and elevated compartment pressures. Unlike traumatic compartment syndrome there have been no documented cases of ischemic limb injury after envenomated patients have received antivenom. Furthermore, there is experimental evidence that fasciotomy worsens myonecrosis. This has led medical toxicologists and surgical guidelines to shift from liberally recommending fasciotomy to near universal recommendation of antivenom alone. Despite this, fasciotomies continue to be recommended and performed on rattle...

Epidemiological and Clinical Behavior of Snakebite in the Pediatric Population, Associated with a Logistic Regression Model

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Epidemiological and Clinical Behavior of Snakebite in the Pediatric Population, Associated with a Logistic Regression Model

Abstract

Introduction: Snakebite envenomation is recognized by the World Health Organization (WHO) as a neglected tropical disease. In Colombia, snakebites are frequent due to the diversity of ecosystems and snake species, and children represent a particularly vulnerable population. Objective: This study aimed to characterize the epidemiological and clinical behavior of snakebite envenomation in the pediatric population and to identify factors associated with its severity through the application of a multinomial logistic regression model. Methods: An exploratory analysis was conducted on 170 pediatric patients reported to the Public Health Surveillance System (SIVIGILA) and treated at San Jerónimo Hospital in Montería (HSJ). Sociodemographic and clinical data were collected, and a multinomial logistic regression model was applied to identify risk factors associated with the severity of envenomation. Results: Most cases occurred in children over 12 years of age (51.8%), and males were the most affected. The lower limbs were the most common site of the bite (87.6%). Bothrops was the main genus responsible. Non-medical practices, such as herbal poultices and potions, were reported in 28.2% of cases. Clinically, moderate envenomation was the most frequent (48.2%), with edema (88%) and pain (92%) as the main local manifestations, and nausea (36%) and vomiting (32%) as systemic manifestations. Cellulitis was the most common complication (24%). Student’s t-test showed a significant difference between complications and hospital stays lasting 3 to 7 days. The multinomial logistic regression explained 75% of the severity variability and showed that prior non-medical practices increased the risk of severe cases. Conclusions: Snakebite envenomation in children remains an important public health problem. The statistical model showed that non-medical practices are associated with a higher degree of severity.

Revollo Vargas, C. (2025). Epidemiological and Clinical Behavior of Snakebite in the Pediatric Population, Associated with a Logistic Regression Model. Clinics and Practice, 15(12), 228. https://doi.org/10.3390/clinpract15120228