Unlike the well-documented bothropic and crotalid snakebites in Brazil, lachetic envenomings (i.e., triggered by the bushmaster snake) are rare and present significant diagnostic challenges. This case describes a severe envenoming induced by a Lachesis muta snake in a 26-year-old Brazilian man who was bitten near a forest in November 2022. Characteristic symptoms such as sweating and bradycardia pointed towards lachetic envenoming, but initial misdiagnosis as a bothropic bite resulted in a delay in appropriate antivenom therapy. Despite later receiving the correct treatment, the severity of the envenoming necessitated the amputation of a finger and triggered a severe infection. This report highlights the challenges of diagnosing and treating Lachesis spp. bites due to their rarity. Moreover, an overview of lachetic-induced signs and symptoms was explored. This study emphasizes that further reports are warranted to improve understanding of Lachesis muta envenoming and to optimize treatment strategies.

The goal of this text is to write about the participation of medical students from the Federal University of Roraima (UFRR) in an extension work that happened in the state of Amazonas. The capacitation was performed by the Tropical Medicine Foundation Heitor Vieira Dourado (FMT-HVD) addressed in Manaus, Amazonas, seeking to show direction about the correct management and treatment of snake envenoming. This action had a target audience of health professionals and medical students. There were 84 participants and it happened in five days with 8 hours per day. During the course there were speeches, clinical case discussion and practice work, for integrating the basic and clinical stage medical and development of clinical skills. This strategy evidenced many health professionals present had preview experience with snake envenoming, but did not know the correct management and even the accurate pharmacological doses. Hence, reporting the experience of training like this is a way to provide medical learning about diseases of local importance, such as snakebite envenomation in the Amazon Region.

In Brazil, snakebites are a critical health issue, particularly in the state of Roraima, where Bothrops species account for the majority of cases. Snake venoms contain multifunctional toxins that cause life-threatening systemic complications and complex wounds, often resulting in permanent disabilities. Although antivenoms have reduced lethality, they fail to prevent the rapid and prolonged action of tissue-damaging toxins at the bite site. As a result, snakebite management is characterized by prolonged hospitalizations and high healthcare costs. Therefore, effective management of these complex wounds is crucial to improving patient outcomes. This article presents a series of four clinical cases involving Bothrops snakebite patients treated at the General Hospital of Roraima. Each case describes the progression of the injury, clinical challenges, interventions, and outcomes. Vacuum-Assisted Wound Therapy (VAWT) was employed as a key component of treatment in all cases, promoting faster granulation tissue formation, infection control, and reduced risk of amputation. The use of VAWT demonstrated significant improvements in wound healing compared to conventional treatment approaches. These findings highlight the potential benefits of VAWT in managing complex snakebite-related wounds, especially in severe cases with high risks of complications. However, barriers such as the high cost of therapy and limited access in remote and resource-poor regions must be addressed to enable broader clinical application.