Aspectos médico-forenses de las muertes por mordedura de serpiente

Abstract

Snakebites represent a highly significant public health problem, particularly in tropical countries such as Costa Rica, where the herpetological diversity and the presence of highly venomous species increase the risk of envenomation. The severity of envenomation depends on multiple interacting factors, including the species involved, the anatomical location of the bite, the amount of venom injected, the condition of the venom glands and fangs, as well as the angle and duration of the bite. Patient-related factors such as age, weight, pre-existing health conditions, and behavior following the incident also influence clinical progression. Ophidian venoms are complex mixtures of bioactive proteins capable of producing hemotoxic, neurotoxic, and cytotoxic effects, acting simultaneously on various organs and systems. In fatal cases, clinical manifestations are often associated with respiratory failure, cardiovascular disturbances, systemic hemorrhage, neurological complications, or acute kidney injury, depending on the predominant toxins and the time elapsed before receiving medical attention. The medicolegal
approach to snake envenomation requires detailed documentation of injuries, a careful analysis of the underlying pathophysiological mechanisms, and correlation with the medicolegal history of the case. Therefore, the aim of this literature review is to analyze the characteristics of fatal snakebite envenomation cases reported in the scientific literature, in order to provide updated evidence that strengthens the medicolegal understanding of these events