Hemorrhagic stroke following viper bites and delayed antivenom administration: three case reports from the Western Brazilian Amazon

Abstract Snakebites were included by the World Health Organization in their list of neglected diseases. In Latin America, most snakebites are caused by species of the Viperidae family, notably by the genus Bothrops. Bothrops atrox accounts for 90% of the cases of envenoming in the Brazilian Amazon. In this report, we present a series of three cases of snakebites that evolved with hemorrhagic stroke due to delays in the access to antivenom in the Brazilian Amazon, being fundamental for diagnosis to validate the clinical suspicion and make decisions that would improve the treatment and prognosis of the patients.

【摘要】世界卫生组织（World Health Organization）已将蛇咬伤纳入其公布的被忽视疾病名录。在拉丁美洲，绝大多数蛇咬伤病例由蝰科（Viperidae）物种引发，其中尤以矛头蝮属（Bothrops）最为常见。在巴西亚马逊地区，矛头蝮（Bothrops atrox）导致的蛇伤中毒病例占总病例的90%。本报告报道了三例巴西亚马逊地区的蛇咬伤病例，患者因抗蛇毒血清（antivenom）获取延迟而继发出血性脑卒中（hemorrhagic stroke）；准确诊断对于验证临床疑似诊断、制定优化患者治疗方案与改善预后的决策具有至关重要的意义。