Cape Town - Delayed treatment of a rare bacterial infection following snake bites by an African spitting cobra could lead to death, research has found, after scientists examined the case of a two-year-old boy who was bitten and suffered multiple organ failure and death.
While wound infections after toxic snake bites were common, bites from the spitting cobra usually presented as severe dermonecrosis, spreading in the connective tissue.
Primary infections could follow during the bite, worsening the effect into infective flesh-eating disease (necrotising fasciitis).
In a new South African Medical Journal article titled “Fatal infective necrotising fasciitis: Complication following Naja nigricincta nigricincta bite (western barred spitting cobra/ zebra snake)”, researchers from Namibia and members of the Namibian Snakebite Interest Group sought to examine a case of the flesh-eating disease.
The African spitting cobra is endemic to central and northern Namibia as well as southern Angola.
It is responsible for most of the venomous snakebites seen in these areas of Namibia. Most bites occurred at night while the victims were asleep, the study explained.
Of the case in question, the research read: “A two-and-a-half-year-old boy was admitted to the emergency department 20 minutes after being bitten by a snake while asleep in his bed.
The snake was found under his pillow, identified as N. n. nigricincta, and removed for relocation by the local snake expert and handler.
On admission, the patient was uncomfortable and restless. There were puncture marks on both his upper and lower right eyelids, with blue discolouration and marked swelling. The right side of his face was slightly swollen. Blood pressure, pulse and respiratory rates, oxygen saturation and temperature were within normal limits.”
His treatment was altered, and a plastic surgery consultation was sought the next morning. Four days and 12 hours after the bite, the boy went into cardiac arrest and could not be resuscitated.
“One of the most important complications of snakebite with local envenoming is soft-tissue infection. Venom causing cytotoxic injuries with extensive tissue destruction and devitalisation predisposes the wound to bacterial infection from the snake’s indigenous oral flora introduced through the fangs,” researchers said.
“The non-recognition or delayed treatment of necrotising fasciitis (flesh-eating diseases) may, in part, be the cause of the high morbidity and mortality observed in children bitten by N. n. Nigricincta.”
Closer to home, snake rescue relocation co-ordinator Shaun MacLeod said it was a busy time of year for him, as he received up to eight calls a day to retrieve Cape cobras.
He said snakes would always try their best to avoid confrontation with humans, but advised that when spotted at home: “Keep about 3m away and watch it, see where it goes.
It’s not going to come back and attack... You need to know where it is, then you phone and I catch it ... I then find a place away from humans, close to water and it goes back into the wild.”
He can be reached on 082 532 5033 or email macadderbite@ yahoo.com
Cape Times