Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review
Snakebite envenoming (SBE) is a public health issue in developing countries. The estimated annual global incidence of snakebites is about 5.4 million snakebites per year, resulting from 1.8 to 2.7 million cases of SBE and from 81,000 to 138,000 deaths with 400,000 survivors suffering permanent physi...
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MDPI AG
2020-11-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/12/11/699 |
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| author | Alessandro Feola Gian Luca Marella Anna Carfora Bruno Della Pietra Pierluca Zangani Carlo Pietro Campobasso |
| author_facet | Alessandro Feola Gian Luca Marella Anna Carfora Bruno Della Pietra Pierluca Zangani Carlo Pietro Campobasso |
| author_sort | Alessandro Feola |
| collection | DOAJ |
| description | Snakebite envenoming (SBE) is a public health issue in developing countries. The estimated annual global incidence of snakebites is about 5.4 million snakebites per year, resulting from 1.8 to 2.7 million cases of SBE and from 81,000 to 138,000 deaths with 400,000 survivors suffering permanent physical and psychological disabilities. There are more than 3000 species of snakes around the world: 600 are venomous and over 200 are considered to be medically important because of their clinical effects. The severity of SBE depends on several factors among which bite localization, snake’s size, condition of glands and teeth, bite angle and bite duration, the microflora of the snake’s mouth and victim’s skin, age of the victim, weight, health status, and victim’s activity after a bite. Snake venoms are mixtures of protein families, and each of these families contains many different toxins or toxin isoforms. Based on their effects, snake venoms can be classified as hemotoxic, neurotoxic, or cytotoxic and they can all act together involving multiple tissues and organs. When the bite is fatal, the mechanism of death is primarily related to the paralysis of respiratory muscles, which causes asphyxia and hypoxic-ischemic encephalopathy, but also anaphylactic shock, hemorrhagic shock, cardiomyopathy, acute tubular necrosis (ATN). The purpose of this literature review is to evaluate epidemiological and post-mortem examination findings in fatal SBEs in order to better understand the pathophysiological mechanisms, thus helping pathologists in defining the correct diagnosis. |
| first_indexed | 2024-03-10T15:07:15Z |
| format | Article |
| id | doaj.art-9db43713fae8448b984d237a1b573ab4 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T15:07:15Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-9db43713fae8448b984d237a1b573ab42023-11-20T19:40:46ZengMDPI AGToxins2072-66512020-11-01121169910.3390/toxins12110699Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic ReviewAlessandro Feola0Gian Luca Marella1Anna Carfora2Bruno Della Pietra3Pierluca Zangani4Carlo Pietro Campobasso5Department Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Luciano Armanni 5, 80138 Naples, ItalyDepartment of Surgical Sciences, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, ItalyDepartment Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Luciano Armanni 5, 80138 Naples, ItalyDepartment Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Luciano Armanni 5, 80138 Naples, ItalyDepartment Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Luciano Armanni 5, 80138 Naples, ItalyDepartment Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Luciano Armanni 5, 80138 Naples, ItalySnakebite envenoming (SBE) is a public health issue in developing countries. The estimated annual global incidence of snakebites is about 5.4 million snakebites per year, resulting from 1.8 to 2.7 million cases of SBE and from 81,000 to 138,000 deaths with 400,000 survivors suffering permanent physical and psychological disabilities. There are more than 3000 species of snakes around the world: 600 are venomous and over 200 are considered to be medically important because of their clinical effects. The severity of SBE depends on several factors among which bite localization, snake’s size, condition of glands and teeth, bite angle and bite duration, the microflora of the snake’s mouth and victim’s skin, age of the victim, weight, health status, and victim’s activity after a bite. Snake venoms are mixtures of protein families, and each of these families contains many different toxins or toxin isoforms. Based on their effects, snake venoms can be classified as hemotoxic, neurotoxic, or cytotoxic and they can all act together involving multiple tissues and organs. When the bite is fatal, the mechanism of death is primarily related to the paralysis of respiratory muscles, which causes asphyxia and hypoxic-ischemic encephalopathy, but also anaphylactic shock, hemorrhagic shock, cardiomyopathy, acute tubular necrosis (ATN). The purpose of this literature review is to evaluate epidemiological and post-mortem examination findings in fatal SBEs in order to better understand the pathophysiological mechanisms, thus helping pathologists in defining the correct diagnosis.https://www.mdpi.com/2072-6651/12/11/699snakebite envenomationautopsytoxicologyneglected tropical disease |
| spellingShingle | Alessandro Feola Gian Luca Marella Anna Carfora Bruno Della Pietra Pierluca Zangani Carlo Pietro Campobasso Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review Toxins snakebite envenomation autopsy toxicology neglected tropical disease |
| title | Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review |
| title_full | Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review |
| title_fullStr | Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review |
| title_full_unstemmed | Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review |
| title_short | Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review |
| title_sort | snakebite envenoming a challenging diagnosis for the forensic pathologist a systematic review |
| topic | snakebite envenomation autopsy toxicology neglected tropical disease |
| url | https://www.mdpi.com/2072-6651/12/11/699 |
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