AEROMONAS-HYDROPHILA SOFT-TISSUE INFECTION AS A COMPLICATION OF SNAKEBITE - REPORT OF 3 CASES

Aeromonas hydrophila soft-tissue infection has been associated with fi sh and reptile bites. There have been three recent cases from Brazil o f abscesses complicating snake bites in which A. hydrophila was isolat ed from the purulent exudates. One of the snakes responsible for the b ites was a specimen of Bothrops moojeni, and the others were most prob ably also lance-headed vipers. These snakes have a local necrotizing, myotoxic, oedema-inducing venom that must have favoured the multiplica tion in the injured tissue of A. hydrophila strains, which were probab ly present in the mouth, fangs or venom of the snakes. The use of a to urniquet by two of the patients probably worsened the local envenoming , and contributed to the occurrence of soft-tissue infection. The pati ents had a good outcome after the abscesses were incised and drained, and after being treated with chloramphenicol. Chloramphenicol appears to be a good alternative for the empirical treatment of soft-tissue in fection complicating snake bite in Brazil, because: it is active again st the majority of the anaerobic and aerobic bacteria found in these a bscesses, including A. hydrophila; it can be administered by the oral route; and it is inexpensive. Suitable alternatives are cotrimoxazole or fluoroquinolones, to which aeromonads are usually susceptible in vi tro, associated with antibiotics, such as clindamycin and metronidazol e, with an anti-anaerobic spectrum.