Cerebral hemorrhage associated with snakebite by Bothrops spp. juvenile: experience of two cases in an Amazonian referral hospital
- 1Universidad Nacional de la Amazonía Peruana, Iquitos, Peru. Universidad Nacional de la Amazonía Peruana Iquitos Peru
- 2Departamento de Enfermedades infecciosas y Tropicales, Hospital Regional de Loreto, Iquitos, Peru. Departamento de Enfermedades infecciosas y Tropicales Hospital Regional de Loreto Iquitos Peru
- 3Instituto Nacional de Ciencias Neurológicas, Lima, Peru. Instituto Nacional de Ciencias Neurológicas Lima Peru
Abstract
Snakes of the genus Bothrops cause most snakebites in Peru. Among its complications, intracranial hemorrhage is infrequent, but potentially lethal. We describe two cases of hemoventricle after bites by juvenile specimens (<50 cm) in Loreto. The first case corresponds to a 58-year-old male with untreated arterial hypertension, who received antivenom in fractionated doses due to shortage. On the fourth day, he presented sudden headache and loss of consciousness; tomography revealed hemorrhage in the fourth ventricle. The second case corresponds to a five-year-old child who received traditional medicine and whose first dose of antivenom was administered after four days of the bite, following a prolonged fluvial transfer. He presented severe anemia, altered sensorium, and hemorrhage in the left lateral ventricle. Both patients required intensive care, additional antivenom, and supportive measures, and were discharged without neurological deficit. These cases illustrate that delayed or insufficient access to antivenom in the Amazon can be associated with hemorrhagic complications of the central nervous system.
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BibTeX
@article{ramirezgarcia2026cerebral,
title = {{Cerebral hemorrhage associated with snakebite by Bothrops spp. juvenile: experience of two cases in an Amazonian referral hospital}},
author = {Edgar A. Ramírez-García and Jorge Sibina Vela and Alfrando Morero and Marco Paredes-Obando and Lidia P. Noriega-Trigoso and Jhosephi J. Vasquez-Ascate and David Crispin-Alvear and Guillermo Velazco-Curay and Juan C. Celis-Salinas and Martín Casapia Morales},
journal = {Revista Peruana de Medicina Experimental y Salud Publica},
year = {2026},
month = sep,
doi = {10.17843/rpmesp.2026.433.15938},
url = {https://doi.org/10.17843/rpmesp.2026.433.15938},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cerebral hemorrhage associated with snakebite by Bothrops spp. juvenile: experience of two cases in an Amazonian referral hospital
AU - Edgar A. Ramírez-García
AU - Jorge Sibina Vela
AU - Alfrando Morero
AU - Marco Paredes-Obando
AU - Lidia P. Noriega-Trigoso
AU - Jhosephi J. Vasquez-Ascate
AU - David Crispin-Alvear
AU - Guillermo Velazco-Curay
AU - Juan C. Celis-Salinas
AU - Martín Casapia Morales
PY - 2026
DA - 2026/09/28
JO - Revista Peruana de Medicina Experimental y Salud Publica
DO - 10.17843/rpmesp.2026.433.15938
UR - https://doi.org/10.17843/rpmesp.2026.433.15938
AB - Snakes of the genus Bothrops cause most snakebites in Peru. Among its complications, intracranial hemorrhage is infrequent, but potentially lethal. We describe two cases of hemoventricle after bites by juvenile specimens (<50 cm) in Loreto. The first case corresponds to a 58-year-old male with untreated arterial hypertension, who received antivenom in fractionated doses due to shortage. On the fourth day, he presented sudden headache and loss of consciousness; tomography revealed hemorrhage in the fourth ventricle. The second case corresponds to a five-year-old child who received traditional medicine and whose first dose of antivenom was administered after four days of the bite, following a prolonged fluvial transfer. He presented severe anemia, altered sensorium, and hemorrhage in the left lateral ventricle. Both patients required intensive care, additional antivenom, and supportive measures, and were discharged without neurological deficit. These cases illustrate that delayed or insufficient access to antivenom in the Amazon can be associated with hemorrhagic complications of the central nervous system.
SN - 1726-4634
SN - 1726-4642
ER -