{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:45:41Z","timestamp":1777934741351,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    Snakebites are a critical health issue in remote regions of the Amazon basin. I report a case of\n                    <jats:italic>Bothrops bilineatus<\/jats:italic>\n                    envenomation in a 29-y-old biologist conducting fieldwork in Parque Nacional del Manu, Peru. Following significant logistic delays\u2014including an initial suboptimal antivenom dose and limited access to additional vials\u2014the patient developed progressive edema, necrosis, coagulopathy, and signs of compartment syndrome. Management involved 2 partial doses of antivenom (1 at 1600 and the other at 2100), a subsequent transfer to a tertiary care center, antibiotics, analgesia, and eventually surgical intervention, including debridement and partial amputation. Although the patient received some treatment on the day of the bite, fragmented antivenom dosing and delayed transport likely contributed to worse local injury. This case highlights the importance of prompt, complete antivenom therapy, effective logistics, advanced diagnostic resources, and comprehensive rehabilitation in resource-limited settings.\n                  <\/jats:p>","DOI":"10.1177\/10806032251337667","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T03:23:38Z","timestamp":1746588218000},"page":"384-388","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["From Forest to Intensive Care Unit: Managing Severe Complications of\n                    <i>Bothrops bilineatus<\/i>\n                    Envenomation"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2579-0712","authenticated-orcid":false,"given":"Percy Josu\u00e9","family":"V\u00e1squez Paredes","sequence":"first","affiliation":[{"name":"EsSalud, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2020.08.010"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008299"},{"issue":"7","key":"e_1_3_2_4_2","first-page":"584","article-title":"Snakebite envenomation: a review","volume":"51","author":"Chippaux J-P","year":"2021","unstructured":"Chippaux J-P, Alencar L, Santos MC, Sachett JAG, Monteiro WM, da Silva T, et al. Snakebite envenomation: a review. Crit Rev Toxicol. 2021;51(7):584\u2013598.","journal-title":"Crit Rev Toxicol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2023.05.007"},{"issue":"7","key":"e_1_3_2_6_2","first-page":"707","article-title":"Is the acute compartment syndrome diagnosed in snake bites true compartment syndrome? A scoping review.","volume":"60","author":"Gaunt MJ","year":"2022","unstructured":"Gaunt MJ, Elliott KG, Johnstone AJ, Roberts T, Richards A, Walker M, et al. Is the acute compartment syndrome diagnosed in snake bites true compartment syndrome? A scoping review. Clin Toxicol (Phila). 2022;60(7):707\u2013719.","journal-title":"Clin Toxicol (Phila)"},{"issue":"21","key":"e_1_3_2_7_2","article-title":"Bothrops snakebite epidemiology and antivenom therapy in the Brazilian Amazon: a 10-year retrospective study","volume":"44","author":"Silva A","year":"2020","unstructured":"Silva A, Saldarriaga S, Stock RP, de Andrade CM, Vila\u00e7a P, Pinheiro J, et al. Bothrops snakebite epidemiology and antivenom therapy in the Brazilian Amazon: a 10-year retrospective study. Rev Panam Salud Publica. 2020;44:e21.","journal-title":"Rev Panam Salud Publica"},{"issue":"4","key":"e_1_3_2_8_2","first-page":"465","article-title":"Rural healthcare challenges in the management of snakebite envenoming: a global perspective","volume":"32","author":"Smith WD","year":"2021","unstructured":"Smith WD, Johnson P, Carter R, Miller L, Davis K, Brown T, et al. Rural healthcare challenges in the management of snakebite envenoming: a global perspective. Wilderness Environ Med. 2021;32(4):465\u2013472.","journal-title":"Wilderness Environ Med"},{"key":"e_1_3_2_9_2","article-title":"Innovations in antivenom distribution: overcoming logistical barriers in remote areas","volume":"556789","author":"Torres M","year":"2021","unstructured":"Torres M, Silva A, G\u00f3mez L, Mart\u00ednez J, Guti\u00e9rrez JM, Alvarez D, et al. Innovations in antivenom distribution: overcoming logistical barriers in remote areas. J Trop Med. 2021;2021:556789.","journal-title":"J Trop Med"},{"issue":"1","key":"e_1_3_2_10_2","first-page":"20","article-title":"The role of advanced imaging in the diagnosis of snakebite-induced compartment syndrome","volume":"6","author":"Carvalho CM","year":"2022","unstructured":"Carvalho CM, Dias LS, Rodrigues F, Pereira R, Ribeiro H, Costa J, et al. The role of advanced imaging in the diagnosis of snakebite-induced compartment syndrome. Eur Radiol Exp. 2022;6(1):20.","journal-title":"Eur Radiol Exp"},{"issue":"2","key":"e_1_3_2_11_2","first-page":"85","article-title":"Long-term outcomes and rehabilitation needs following snakebite envenomation in the Amazon","volume":"47","author":"Dantas LC","year":"2022","unstructured":"Dantas LC, Oliveira P, Souza R, Lima F, Santos V, Cruz A, et al. Long-term outcomes and rehabilitation needs following snakebite envenomation in the Amazon. Rehabil Nurs. 2022;47(2):85\u201391.","journal-title":"Rehabil Nurs"},{"issue":"12","key":"e_1_3_2_12_2","article-title":"Economic and social impacts of snakebite envenomation in rural Latin America","volume":"15","author":"Martinez J","year":"2021","unstructured":"Martinez J, Gutierrez JM, Alvarez D, Silva A, Torres M, G\u00f3mez L, et al. Economic and social impacts of snakebite envenomation in rural Latin America. PLoS Negl Trop Dis. 2021;15(12):e0009981.","journal-title":"PLoS Negl Trop Dis"},{"issue":"8","key":"e_1_3_2_13_2","first-page":"979","article-title":"Preventive strategies and first aid education for snakebite management: a community-based intervention in the Amazon","volume":"27","author":"Garc\u00eda-Morales J","year":"2022","unstructured":"Garc\u00eda-Morales J, Romero R, Vega M, S\u00e1nchez F, Fern\u00e1ndez L, Ruiz A, et al. Preventive strategies and first aid education for snakebite management: a community-based intervention in the Amazon. Trop Med Int Health. 2022;27(8):979\u2013987.","journal-title":"Trop Med Int Health"},{"issue":"4","key":"e_1_3_2_14_2","first-page":"1105","article-title":"The evolution of snakebite management protocols in Latin America: a review of recent guidelines","volume":"105","author":"Zamudio V","year":"2021","unstructured":"Zamudio V, Herrera M, Salinas F, L\u00f3pez R, Torres A, Mendoza S, et al. The evolution of snakebite management protocols in Latin America: a review of recent guidelines. Am J Trop Med Hyg. 2021;105(4):1105\u20131112.","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"e_1_3_2_15_2","first-page":"245","article-title":"Blister formation and skin damage induced by BaP1, a haemorrhagic metalloproteinase from the venom of Bothrops asper","volume":"79","author":"Rucavado A","year":"1998","unstructured":"Rucavado A, N\u00fa\u00f1ez J, Guti\u00e9rrez JM. Blister formation and skin damage induced by BaP1, a haemorrhagic metalloproteinase from the venom of Bothrops asper. Int J Exp Pathol. 1998;79(4):245\u2013254.","journal-title":"Int J Exp Pathol"},{"issue":"100037","key":"e_1_3_2_16_2","article-title":"Bothrops atrox, the most important snake involved in human envenomings in the Amazon: how venomics contributes to the knowledge of snake biology and clinical toxinology","volume":"6","author":"Monteiro WM","year":"2020","unstructured":"Monteiro WM, Contreras-Bernal JC, Bisneto PF, Sachett JAG, da Silva IM, Lacerda MVG, et al. Bothrops atrox, the most important snake involved in human envenomings in the Amazon: how venomics contributes to the knowledge of snake biology and clinical toxinology. 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