The relationship between laboratory and clinic in childhood snake bites

Introduction and Purpose: Snakebites represent a significant public health concern in Turkey and globally, capable of causing severe medical complications and fatalities. Children are particularly vulnerable to snakebite-related complications compared to adults due to their lower body mass index. This study conducted at Dicle University Faculty of Medicine, Department of Pediatrics, aimed to evaluate the demographic, clinical, and laboratory characteristics of pediatric snakebite cases to assess clinical-laboratory correlations. Materials and Methods: This study is a clinical, retrospective, cross-sectional investigation. It includes data from patients who presented with snake bites to the Department of Pediatrics at Dicle University Faculty of Medicine between January 1, 2011, and October 31, 2024. The patients were categorized into two groups—mild cases and moderate-to-severe cases—and their data were compared accordingly. Results: Out of the 88 patients included in the study, 49 (55.7%) were male and 39 (44.3%) were female. The majority of cases (51.1%) were in the 6–11 age group. The most frequent time of presentation was between 12:00 and 17:59 (37.5%), and the most common season for admissions was summer (61.4%). The lower extremities were the most commonly affected body region (67.1%). While pain was observed in all patients, erythema (76.1%) and edema (36.4%) were present at lower frequencies. According to clinical staging, 28.4% of cases were Stage 1, 44.3% Stage 2, 14.8% Stage 3, and 12.5% Stage 0. Antivenom treatment was administered to 59.1% of patients. Blood product usage was identified in 10.2% of cases, and splint or cast application was observed in 30.7% of patients. The most common complication was compartment syndrome (6.8%). When comparing mild cases (40,9%) with moderate-to-severe cases (59.1%), local findings such as erythema, ecchymosis, and necrosis, along with antivenom administration and intensive care requirement, were significantly more frequent in the moderate-to-severe group (p<0.05). Interestingly, cellulitis was observed only in the mild group (p<0.05). Regarding laboratory parameters, blood urea nitrogen and ALT levels were significantly higher in the moderate-to-severe group (p<0.05), while no statistically significant differences were found in other hematological, biochemical, or coagulation parameters between the two groups. Conclusion: This study suggests that in pediatric snakebite cases, local findings such as erythema, ecchymosis, and necrosis, along with the need for antivenom therapy and elevated urea and ALT levels, may be associated with a moderate-to-severe clinical course and the development of complications. The marked increase in cases during the summer months highlights the clinical importance of early recognition of these parameters to identify high-risk patients promptly and to enhance the effectiveness of treatment strategies.