HIGH RESOLUTION INFRARED THERMOGRAPHY IN MONITORING POISONOUS ANIMAL BITES IN URUGUAY

Resumo

HIGH RESOLUTION INFRARED THERMOGRAPHY IN MONITORING POISONOUS ANIMAL BITES IN URUGUAY  
Introduction: The Toxicological Information and Advice Centre records bites by Bothrops and Loxocesceles Laeta. There is difficulty in assessing local phenomena . Thermography is used in several medical specialties; non-contact thermography does not generate ionizing radiation. We describe its use in monitoring local inflammation due to poisoning. Cases: 1: Man, 36 years old, bitten by Bothrops Pubescens on his left foot. After 18 days, he presented with severe pain, edema, redness, and warmth, with leukocytosis (15.8 x 10 3 /L) and CRP levels of 43 mg/L. 2: Man, 46 years old, bitten on the inner part of the right thigh by Bothrops Alternatus . On the 4th day, intense pain, extensive edema, hematoma with blisters. Leukocytes of 10.8 x 10 3 / L, CRP of 10 mg/l. 3 : 65-year-old woman, anterior thoracic injury, 10 days of evolution with liveloid plaque and ulcer. 4: Male, 33 years old, bite lasting 8 days, left index finger, second phalanx with distal cyanosis, coldness and areas of necrosis. Discussion: The cases present thermal asymmetries with ∆T values greater than 1°C, reported by Medeiros et al 2017. Case 1 presents a ∆T = 4.02°C, Machado et al 2023, report clinical cases with ∆T values greater than 2.2°C and their relationship with infection markers. Case 2 presents ∆T = 1.36°C, Sabitha et al 2021 describe inflammatory patterns with ∆T less than 1.5°C. In case 3, the liveloid plaque presents a thermal pattern with areas of perfusion and hypovascular areas , ∆T= 1.72°C . These can be attributed to changes in the local microcirculation with ∆T described by Medeiros et al 2017. Case 4 the IR shows the presence of distal flow at the level of the second phalanx, with ∆ T = 3.50° C, receiving conservative treatment and not requiring amputation. Thermography could complement the toxicologist's bedside assessment with objective data from ∆T, assessing possible risks of infection or necrosis, the thermal pattern of the liveloid plaque , as well as distal perfusion, avoiding unnecessary amputations in the extremities. A prospective study is being carried out in Uruguay to obtain statistical significance. Keywords: Bothrops ;Liveloid ; Loxosceles ; Delta T