Acute neuromuscular paralysis, rhabdomyolysis and long lasting neurological deficits in Ceylon krait (Bungarus ceylonicus) bites: Two authentic cases from a serpentarium in Sri Lanka

Autor: S.A.M. Kularatne, Anuradha Colombage, Anslem de Silva, Vajira Weerasinghe, R.M.M.K. Namal Rathnayaka
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Toxicon: X, Vol 4, Iss , Pp - (2019)
Druh dokumentu: article
ISSN: 2590-1710
77389948
DOI: 10.1016/j.toxcx.2019.100015
Popis: The Ceylon krait (Bungarus ceylonicus) is a highly venomous elapid snake endemic to Sri Lanka. Its bites are rare and only seven reports are found in the literature. Therefore, the clinical manifestations and natural history of envenoming of Ceylon krait are not well studied yet. Neuroparalysis is the main clinical manifestation of their bites. We report two cases of proven Ceylon krait bites of two young snake keepers working in a serpentarium. They developed acute neuroparalysis, abdominal pain and a period of amnesia. The first patient developed myalgia and increased level of serum creatine kinase suggestive of rhabdomyolysis. One was treated with Indian polyvalent antivenom and both recovered with some long-lasting clinical disabilities namely impairment of sensation of the bitten arm and persistent refraction errors in the eyes in the first patient. The second patient had persistent marked nystagmus. Keywords: Snakebites, Ceylon krait, Bungarus ceylonicus, Neuroparalysis, Sri Lanka
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