Snake bite accidents happen more frequently in rural area from July to September annually. Of the species of snake native to the Korea, 3 species was known to be poisonous and clinical characteristics of the venomous effect on human in Korea
seemed
to
similar to Pit Vipers in U. S. A. than coral snakes. Death from the snake bite in Korea are rare but morbidity was not low and severe complications may ensues if not appropriate treatment given. Even though antivenin has been used, but its
effects
remain controversial. The purpose of this report is to describe the characteristics of the shake bites in Korean rural area and study the effect of polyvalent antivenin. We analyzed 223 victims, who admitted to Young In and Kwang Ju Severance
Hospital
for 5 years from June, 1987 to June, 1992.
@ES The results were as follows:
@EN 1) The male to female ratio was 1.8 : 1. The incidence of peak age was 3rd and 5th decade. The seasonal distribution was prominent in July, August and September.
2) The most frequent place the accident happened was the field(50.2%) and predirection site of the body was finger(39%).
3) Local sign and symptom such as pain and edema was noted in all cases and blurred vision, dizziness was the most common symptoms.
4) According to the grade for severity, grade I was most common (63%) and grade II was 28.7%. The grade III or IV was rare.
5) Leukocytosis was observed in 43 cases(33.6%) and anemia was also noted in 4 cases. Microscopic hematuria and elevated liver enzymes were noted in 42 cases(31.3%), 30 cases(28%), respectively, coagulopathy abnormalities were noted in 6 cases.
6) Conservative treatment was performed in all cases and antivenin was used in 126 cases(56.5%). The amount of antivenin usuage was 10 ml in 101 cases(80.2%) and then time of its usuage was less than 1 hour in 52 cases(41.2%).
7) The complication of the bites was occurred in 18 cases(8.1%), those of which, cellulitis was 6 cases(2.7%), tissue necrosis 4 cases(1.7%). The serous complication was acute renal failure 1 cases(0.4%) ad disseminated intravascular
coagulopathy
3
cases(1.3%).
8) The side effect of antivenin was anaphylactic shock(1 cases), serum sickness(1 cases) and urticaria(7 cases).
9) Comparison of hospital stays between antivenin used group and non-used group showed no different(p>0.05) and the frequency of complication no different.
Clinical characteristics of snake bites in Korean rural area was mainly grade I. II envenomation and venomous effect on human was neurologic, coagulative abnormalities and liver dysfunction. The effect of polyvalent antivenin semen to be doubtful
and
potentially hazardous, so newly developed antivenin for Korean snakes would be needed.
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