Pemberian SABU (Serum Anti-Bisa Ular) untuk Kasus Gigitan Ular Awitan Lama dengan Komplikasi Disseminated Intravascular Coagulation (DIC)

Authors

  • Dedy Kristofer Simangunsong Dokter Umum
  • Hadiki Habib RSCM Jakarta
  • Eirene Simbolon RSON Jakarta

DOI:

https://doi.org/10.55175/cdk.v51i3.941

Keywords:

Antivenom, snakebite, SABU

Abstract

Background: Snakebite is a neglected disease in subtropical and tropical countries in Asia, Africa, and Latin America. Snakebite is one of the most common venomous animal bites in the world. Case: A 34-year-old male presented with a history of snakebite two days before with a swollen left gluteus and spontaneous gum bleeding. At the emergency room, the patient was fully conscious with blood pressure of 120/80 mmHg, temperature of 36.8oC, pulse rate of 80 beats per minute, and respiration rate of 18 times per minute. Blood studies showed prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), leucocytosis, thrombocytopenia, low hemoglobin, and elevated renal function test. The patient's condition was improved after administration of anti-snake venom, vitamin K injection, transfusion of fresh frozen plasma and packed red cells. He was discharged after three days of hospital stays. Conclusion: Antivenom is the only specific antidote to snake venom; in Indonesia, there is only one local antivenom, commonly known as SABU (serum anti-bisa ular). Inappropriate use of antivenom should be strongly discouraged. Administration of the antivenom should be accompanied by preparedness for anaphylaxis risk.

Downloads

Download data is not yet available.

References

Jeon YJ, Kim JW, Park SG, Shin, DW. Risk factor, monitoring, and treatment for snakebite induced coagulopathy: A multicenter retrospective study. Acute Crit Care 2019;34(4):269-75.

World Health Organization Regional Office South-East Asia. Guidelines for the management of snakebites. 2nd Ed [Internet]. 2019. [cited 2022 December 1]. Available from: https://www.who.int/publications/i/item/9789290225300.

Pucca MB, Knudsen C, Oliveira IS, Rimbault C, Cerni FA, Wen FH , et al. Current knowledge on snake dry bites. Toxins 2020;12:668. DOI:10.3390/toxins12110668.

Engels D, Zhou X. Neglected tropical diseases: An effective global response to local poverty-related disease priorities. Infect Dis Poverty 2020;9:10.

Hifumi T, Sakai A, Kondo Y, Yamamoto A, Morine N, Ato M, et al. Venomous snake bites: Clinical diagnosis and treatment. J Intensive Care 2015;3:16.

Gómez-Betancur I, Gogineni V , Salazar-Ospina A, León F. Perspective on the therapeutics of anti-snake venom. Molecules 2019;24:3276.

Knudsen C, Jürgensen JA, Føns S, Haack AM, Friis RUW, Dam SH, et al. Snakebite envenoming diagnosis and diagnostics. Frontiers in Immunology 2021;12:661457.

Williams HF, Layfield HJ, Vallance T, Patel K, Bicknell AB,Trim SA, et al. The urgent need to develop novel strategies for the diagnosis and treatment of snakebites. Toxins 2019;11:363.

Shafie NA, Fauzi H, Wahab MSA, Senek MZF, Ismail AK. The prevalence of hypersensitivity reactions to snake antivenoms administered in Sultanah Nur Zahirah Hospital from 2013 to 2016. Med J Malaysia 2020;75(3):217.

Johnson C, Rimmer J, Mount G, Gurney I, Nicol ED. Challenges of managing snakebite envenomation in a deployed setting. J Royal Army Medical Corps. 2013;9(4):307-11.

Bolon I, Durso AM, Mesa SB, Ray N, Alcoba G, Chappuis F, et al. Identifying the snake: First scoping review on practices of communities and healthcare providers confronted with snakebite across the world. PLOS One 2020;15(3):e0229989.

Tan CH, Liew JL, Tan KY, Tan NH. Assessing SABU (serum anti bisa ular), the sole Indonesian antivenom: A proteomic analysis and neutralization efficacy study. Scient Rep. 2016;6:37299.

Kementerian Kesehatan Republik Indonesia. Buku pedoman penanganan gigitan, sengatan hewan berbisa dan keracunan tumbuhan dan jamur. Direktorat Pencegahan dan Pengendalian Penyakit; 2023 .p. 53.

Alwi I, Salim S, Hidayat R, Kurniawan J, Tahapary DL. Penatalaksanaan di bidang ilmu penyakit dalam panduan praktik klinis. Interna Publishing Pusat Penerbitan Ilmu Penyakit Dalam; 2019 .p. 25-7.

Published

01-03-2024

How to Cite

Simangunsong, D. K., Hadiki Habib, & Simbolon, E. (2024). Pemberian SABU (Serum Anti-Bisa Ular) untuk Kasus Gigitan Ular Awitan Lama dengan Komplikasi Disseminated Intravascular Coagulation (DIC). Cermin Dunia Kedokteran, 51(3), 149–155. https://doi.org/10.55175/cdk.v51i3.941

Issue

Section

Articles