Table 2. Surgical outcome or wound bacteriology in eight envenomed patients.
Case number | Body part bitten | Clinical manifestations | Intravenous antibiotic administered before surgery | Type of surgery | Time after bite to surgery in days | Hospital stay in days | Outcome | Bacterial culture |
---|---|---|---|---|---|---|---|---|
Case 1 | Finger | Swelling and pain, ecchymosis, lymphadenitis/lymphangitis, bullae/blister, fever, wound necrosis, wound infection | Cefazolin and metronidazole | Debridement < 5 cm | 7 | 11.9 | Recovery | Wound swab and blood culture: both negative |
Case 2 | Finger | Swelling and pain, wound necrosis, wound infection | Ceftriaxone and clindamycin | Debridement < 5 cm | 7 | 10 | Recovery | Wound swab after debridement: Pseudomonas aeruginosa |
Case 3 | Finger | Swelling and pain, ecchymosis, bullae/blister, wound necrosis, wound infection | Amoxicillin/clavulanic acid | Debridement 5-10 cm | 11 | 7.6 | Recovery | Wound swab after debridement: Enterobacter cloacae |
Case 4 | Finger | Swelling and pain, bullae/blister, wound necrosis, wound infection | Amoxicillin/clavulanic acid | Debridement < 5 cm Debridement < 5 cm Debridement < 5 cm Full-thickness skin graft | 3 13 21 24 | 5.9 | Recovery | Wound swab after first debridement: Morganella morganii |
Case 5 | Finger | Swelling and pain, ecchymosis, bullae/blister, local numbness, wound necrosis, wound infection | Oxacillin | Debridement < 5 cm | 6 | 8.8 | Recovery | Bullae fluid: Staphyloccocus hominis |
Case 6 | Forearm | Swelling and pain, ecchymosis, local numbness, suspected ACSa | Cefazolin and gentamicin | Fasciotomy Debridement > 10 cm and split-thickness skin graft Revision of scar | 0.33 5 59 | 11.8 | Recovery | Not performed |
Case 7 | Finger | Swelling and pain, wound infection | No antibiotic | Not performed | - | 8.1 | Recovery | Joint fluid: Citrobacter freundii |
Case 8 | Finger | Swelling and pain, local numbness, lymphadenitis/lymphangitis, bullae/blister, wound necrosis, wound infection | Cefazolin and metronidazole | Not performed | - | 3 | Recovery | Wound swab: Staphylococcus aureus, Enterobacter cloacae; Veillonella sp. (anaerobic) |
Acute compartment syndrome.