B. Omaña
Servicio de Toxicología, Hospital "Dr. Leopoldo Manrique Terrero", Caracas, Venezuela.
Envenomation by Tityus discrepans has a high incidence in the upper regions of Miranda State and in the metropolitan area of Caracas in the central north region of Venezuela. It is the major cause of envenomings seen at the "Dr. Leopoldo Manrique Terrero" Hospital in Caracas. Our Toxicology Service has classified the envenomed patients as asymptomatic, mildly, moderately or severely envenomed. Although this classification does not have clinimetric parameters, the signs and symptoms are sufficient to classify the stung individuals as mentioned above. The factors time and age are important in the severity and extent of the manifestations. An envenomation that causes repeated vomiting episodes within 20 min is more severe than that which causes less vomiting episodes over 4 h. Our criteria for the specific treatment and medical procedures are summarized in the following table.
In 1996, 579 envenomed patients were diagnosed using epidemiological, clinical, and laboratory parameters, especially amylase and glycemia. Of these patients, 88.9% were seen at the outpatient clinic and 11% received assistance by telephone. El Junquito, Los Teques, Los Ocumitos, and Petare (Miranda State) showed the highest incidence of envenomings. 55.8 percent of the envenomings were recorded between May and August. The age distribution of the envenomed patients was: 16.5% between 15 and 19 years old, 14.1% between 20 and 24 years old, and 11.2% between 30 and 34 years old. Males were the most affected, in contrast with data from the 5 previous years when there was no difference between the sexes. The body extremities were the most affected anatomical regions. The patients were classified as asymptomatic (86.5%), mildly envenomed (11.2%), moderately envenomed (1.7%), or severely envenomed (0.5%). The most frequent complication was pancreatitis. In 1997, 694 envenomed patients were seen between January and October, an increase in the number of patients seen at the outpatient clinic. Males were the most affected, and 70.3% of the cases occurred between May and September. The locality with the highest incidence was El Junquito. It is worth noticing that the patients between 30 and 34 years old from El Junko Urbanization developed moderate clinical symptoms, and a 27-year-old patient from Los Ocumitos developed pancreatitis. The individuals were clinically classified as asymptomatic (83.5%), mildly envenomed (12.9%), moderately envenomed (2.7%), or severely envenomed (0.7%). Our results show a 7% increase in envenomation cases treated up until October 1997 in comparison to 1996.
Publication Dates
-
Publication in this collection
16 Apr 1999 -
Date of issue
1999
