C Valsan, T Rao, A Sathiavathy
morganella morganii, septic wound, snake bite
C Valsan, T Rao, A Sathiavathy. A case of Snakebite complicated by Morganella morganii subspecies morganii Biogroup I infection. The Internet Journal of Infectious Diseases. 2007 Volume 6 Number 2.
A case of
Snake bite carries the consequences of envenomation primarily but also can produce a lesion at the bite site with extensive necrosis. The dead tissue can secondarily get infected by bacteria coming from the snake's mouth that may be inoculated at the moment of bite (1). Till recently very little was known about the bacteria responsible for the infection. In the recent past
A 38 year old female was admitted to the surgical casualty ward after being bitten by a suspected poisonous snake on the right thumb. Patient was given anti-snake venom and prophylactic antibiotics (Ampicillin + Cloxacillin 500 mg IV 8 th hourly) along with other first aid measures.
On the 3 rd day the patient developed cellulitis with an abscess on the dorsum of the hand. Abscess was drained and patient was put on a changed regime of broader spectrum antibiotics (Amoxicillin + Clavulanic acid) to cover the beta lactamase producing strains. But the abscess recurred and the patient had to undergo repeated incision and drainage. The direct smear made from these pus samples showed plenty of pus cells with gram negative bacilli on gram staining.
All the samples on culture grew
Soft tissue infections can be an important complication of snakebite with local envenoming. Various origins of bacteria at the site of venomous snakebite have been considered. Culture of fang, fang sheath and venom of snakes like Bothrops, Vipers, Rattlesnake and Naja naja had shown heavy colonization with many bacteria (2,4,5). These include Enterobacteriaceae like
Other sources suggested include the victim's cloths and skin which were pierced by the fangs of the snake, or other unsterile substances applied to the site of bite. In hospitalized patients the bacteria from the hospital could contaminate the lesion and cause nosocomial infection. In one prominent study
The present case report enlightens the role of bacteriological culturing of septic materials from primarily and secondarily infected snake bite wounds and starting on appropriate antibiotics at the earliest to prevent the disabling complications.