Table 1 Patient Characteristics
First author, year of publication, study design | Patient number, age, gender,profession | Region of Cameroon and site of the incident | Site of snake bite on the body | Snake species | Delay before hospital presentation | Signs of envenomation | Management | Outcome |
|---|---|---|---|---|---|---|---|---|
Nkwescheu [10], 2016, case report | Patient 1; 28 year, male, physician | Northern Cameroon, in bedroom | Right hand | Naja melanoleuca | Within an hour | Swollen hand, rigors, foaming at the mouth, loss of speech and severe respiratory distress. | One vial AVS, Fluid resucitation, Atropine 1 mg IV, Ranitidine 50 mg IV, Paracetamol 500 mg IV. | fatal |
Tianyi, 2017 [11], case report | Patient 2: 10 years, female, occupation not precised | Adamawa region, in the farm | Right temple | Unidentified snake species | 12 h | Marked facial swelling, haematuria, pain, bleeding from the wound and mouth, mild respiratory distress. | Topical application and oral ingestion of herbal concoctions, 1 vial of AVS, 1500 IU anti-tetanus serum SC, dexamethasone 4 mg IV every 8 h, ceftriaxone 450 mg every 12 h, wound dressing, Normal saline 100 ml/h. | Complete recovery |
Tianyi, 2018[12], case series of two patients | Patient 3: 80 years, male, traditional healer | Adamawa region, in the bush | Left leg | Naja melanoleuca | Died on the way to the hospital | Inability to stand, and difficulties in speaking, loss of consciousness. | Application of traditional topical ointments on the wounds, ingestion of herbal concoctions, no AVS administered. | fatal |
Patient 4: 3 years, female | Adamawa region, in the bush | Left leg | Unidentified snake species | Four hours | Inability to stand, talk and open her eyes, breathing difficulties, convulsion, a state of shock. | Tourniquet applied on left thigh, fluid resuscitation, 750 IU anti-tetanus serum SC, dexamethazone 4 mg IM, AVS not available. | fatal | |
The present case report | Patient 5: 47 years old female farmer | Centre region, in the farm | Right thumb | Echis occellatus | 20 h | a state of shock, acute kidney injury, coagulopathy and gangrene. | Topical application and oral ingestion of herbal, concoctions, fluid resuscitation, anti-tetanus serum 1500 IU SV, ceftriaxone 2 g/24 h IV, metronidazole 500 mg/8 h IV, adrenaline 1:1000 dilution at 0.2 mg every 5 min IV, promethazine 25 mg/8 h IV, Paracetamol 1 g/06 h IV, tramadol 100 mg/8 h IV, methylprednisolone 80 mg/kg IV, three vials of polyvalent anti-venom sera IV, Noradrenaline 0.3/kg/min using EPS, and transfusion of three units of fresh frozen plasma. | fatal |