Timely Response to Severe Fer-de-lance Snakebite at Los Teques Hospital: Fundación Vivarium Applies Its Experimental Severity Scale

fundacionvivarium
Jun 20
2 min read

Los Teques, June 2025 — A severe snakebite envenomation case was recently treated at the Victorino Santaella Hospital, where Mr. Luis Castellón presented with extensive injuries to his left foot, consistent with a Bothrops (commonly known as mapanare or fer-de-lance) envenomation.

The Vivarium Foundation team gained access to the case thanks to coordination with local healthcare personnel and applied its new experimental tool: the Dynamic Clinical Severity Scale, currently under trial with over 30 real cases across Venezuela. This tool aims to provide healthcare professionals with a practical, visual, and reliable instrument to estimate envenomation severity and guide real-time clinical decision-making.

A Step That Changed Everything

Luis did not notice the snake and accidentally stepped on it, triggering the bite. Once at the hospital, a video of the case was shared on social media. After observing the seriousness of the injuries, Fundación Vivarium’s team decided to visit the hospital to offer support to the patient and to document the case firsthand, as part of its educational and clinical strengthening mission.

Clinical Findings in the Patient

Massive and tense edema, with evident skin distension from the foot to the lower leg.
Multiple hemorrhagic blisters, large and filled with dark serohematic fluid, especially on the heel and dorsum of the foot.
Early signs of necrosis, with purplish discoloration and cyanotic skin between blisters.
Reduced mobility and severe pain, suggesting neuromuscular or vascular compromise.
Estimated score on the Fundación Vivarium Dynamic Clinical Severity Scale: 11–12 points, corresponding to severe envenomation.

Medical Response and Evolution

Thanks to timely medical intervention, the patient received polyvalent antivenom, and lab tests confirmed that the envenomation had been effectively neutralized. He is currently hospitalized and under close observation, with continuous clinical monitoring.

The current challenge is the functional recovery of the affected limb..

What Comes After Surviving the Envenomation?

Recovery from a severe fer-de-lance bite does not end with antivenom administration. A structured post-envenomation recovery process is essential and typically involves:

Pain control and close monitoring, especially for infection or compartment syndrome.
Surgical evaluation: If necrosis or signs of ischemia progress, debridement or fasciotomy may be required in extreme cases.
Early physiotherapy (when medically safe), to prevent loss of mobility and strengthen the affected limb.
Renal and hematologic monitoring, to detect potential systemic complications.
Emotional and psychological support, particularly in cases of chronic pain, trauma, or post-bite anxiety.
Multidisciplinary outpatient follow-up (trauma, infectious disease, rehabilitation), potentially lasting weeks or months.

Acknowledgments and Commitment

Vivarium Foundation sincerely thanks the medical team at Victorino Santaella Hospital and the Department of Epidemiology for their swift response. We reaffirm our commitment to education, prevention, and informed support in snakebite cases throughout Venezuela.

We will continue to document real-life cases, enhance our clinical severity scale, and make it publicly available to all healthcare providers in the country — to help save more lives and reduce long-term consequences.

📢 To support our work or learn more about our programs, visit:www.fundacionvivarium.org