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Contact with Lonomia caterpillars can cause a hemorrhagic syndrome. In Brazil, Lonomia obliqua and Lonomia achelous are known to cause this venom-induced disease. In the Brazilian Amazon, descriptions of this kind of envenomation are scarce. Herein, we report a severe hemorrhagic syndrome caused by Lonomia envenomation in the Amazonas state, Western Brazilian Amazon. The patient showed signs of hemorrhage lasting 8 days and required Lonomia antivenom administration, which resulted in resolution of hemorrhagic syndrome. Thus, availability of Lonomia antivenom as well as early antivenom therapy administration should be addressed across remote areas in the Amazon.

Micrurus snakes, commonly known as coral snakes, are responsible for 0.4% of the snakebites envenomings in Brazil. In this report, we describe a case of envenoming by Micrurus averyi, the black-headed coral snake, recorded in the western Brazilian Amazon. To the best of our knowledge, this is the first published case perpetrated by this species. The major complaint of the patient was an intense local pain and paresthesia. Examination of the bite site revealed edema extending from the left foot up the left leg that was accompanied by erythema involving the foot and distal third of the leg. Systemic signs at admission included nausea and drooling. The patient was treated with 100 mL of coral snake antivenom and intravenous analgesics (dipyrone) and was discharged 48 h post-admission with no complaints. The patient showed more intense local edema than that generally described in several other cases of Micrurus bites in Brazil.

Scorpion stings are a public health problem in the Brazilian Amazon. However, detailed clinical characterization with the proper animal identification is scarce. Here we report a confirmed case of envenoming by Tityus cf. silvestris in the Brazilian Amazon. The case evolved with generalized muscle spasms and was treated with antivenom and supportive therapy, requiring intensive care unit admission. The patient evolved favourably and was discharged after 9 days of hospitalization.

INTRODUCTION: Snake bite, a problem in public health, generally occurs where there is no electric power. METHODS: A comparative clinical study was conducted with 102 victims of Bothrops snake bite, from the state of Amazonas, Brazil; 58 victims were treated with liofilizated trivalent antivenom serum (SATL) and 44 victims treated with liquid bivalent and monovalent antivenom serum (SAMBL). RESULTS: 17% (10/58) of patients presented adverse effects with the SATL and 25% (11/44) with the SAMBL. CONCLUSIONS: There was no statistic difference in number of adverse effects between the two types of snake bite antivenom. INTRODUÇÃO: Acidente ofídico, problema de Saúde Pública, é mais frequente onde não há energia elétrica. MÉTODOS: Foi realizado estudo clínico comparativo com 102 vítimas de acidente botrópico, do Estado do Amazonas, Brasil; 58 vítimas tratadas com soro antiofídico trivalente liofilizado (SATL) e 44 vítimas tratadas com soro antiofídico monovalente e bivalente líquido (SAMBL). RESULTADOS: A comparação entre os tipos de soro demonstrou 17% (10/58) de indivíduos com eventos adversos com o uso de SATL e 25% (11/44) com o uso dos SAMBL. CONCLUSÕES: Não houve diferença estatística na quantidade de reações adversas entre os dois tipos de soros antiofídicos.