Two rare case reports of confirmed Ceylon krait (Bungarus ceylonicus) envenoming in Sri Lanka

Rathnayaka, R.M.M.K. Namal; Kularatne, S.A.M.; Kumarasinghe, K.D.M.; Jeganadan, K.; Ranathunga, P.E. Anusha Nishanthi

doi:10.1016/j.toxicon.2017.01.003

Cited by 6 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In one study, hypokalemia reportedly occurred in 71% of patients with common krait ( Bungarus caeruleus ) envenomation. 34 The authors explained that the hypokalemia might have been caused by a shift of potassium into cells secondary to beta-adrenergic stimulation due to autonomic dysfunction. 34 In one case report, a patient who had been bitten by a Sind krait ( Bungarus sindanus ) developed severe autonomic disturbances and cardiac complications during hospitalization and had hypokalemia (potassium of 3.0 mmol/L) on admission.…”

Section: Discussionmentioning

confidence: 99%

“… 34 The authors explained that the hypokalemia might have been caused by a shift of potassium into cells secondary to beta-adrenergic stimulation due to autonomic dysfunction. 34 In one case report, a patient who had been bitten by a Sind krait ( Bungarus sindanus ) developed severe autonomic disturbances and cardiac complications during hospitalization and had hypokalemia (potassium of 3.0 mmol/L) on admission. 14 Nonetheless, hypokalemia has not been reported in patients with Malayan krait envenomation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Krait envenomation in Thailand

Tongpoo

Sriapha

Pradoo

et al. 2018

TCRM

View full text Add to dashboard Cite

PurposeThree species in the genus Bungarus inhabit Thailand. Among these, Bungarus candidus (Malayan krait) is the most common and deadliest. Currently, the clinical manifestations of patients envenomed by kraits, especially Bungarus fasciatus (banded krait), have not been thoroughly investigated. This study was performed to elucidate the clinical manifestations and outcomes of patients bitten by kraits in Thailand.Materials and methodsThe data of krait envenomation cases that occurred during a 9-year period were obtained from the Ramathibodi Poison Center Toxic Exposure Surveillance System and retrospectively analyzed.ResultsIn total, 78 cases of krait envenomation were included. Most patients were male (59.0%) and the median age was 28 years. All had minimal local effects. The median duration from the bite to the onset of neurological manifestations was 3 hours (range, 0.5–8 hours). Besides neurological effects, the patients also developed high blood pressure (67.4%), tachycardia (61.7%), hypokalemia (55.3%), and hyponatremia (17.6%). Severe hyponatremia (<120 mEq/L) was noted in four pediatric patients. Other clinical manifestations were bradycardia, abdominal pain, and rhabdomyolysis. The mortality rate was 6.4%, and all deaths occurred from B. candidus bites. Eighty-six percent of patients received antivenom. Most patients (75.6%) were intubated and underwent assisted ventilation for a median of 6 days (range, 1–37 days). The median length of hospital stay was 7 days. Some patients developed complications during hospitalization; the most common was pneumonia. These in-hospital complications were significantly associated with death.ConclusionAlthough krait bites caused only minimal local effects, the mortality rate was still high, particularly from Malayan krait bites. Besides neurological effects, other clinical manifestations were high blood pressure, tachycardia, hypokalemia, and hyponatremia. Thus, vital signs and electrolytes should be frequently and closely monitored in these patients. Apart from antivenom treatment, adequate supportive care including management of complications might help to decrease the mortality rate.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Krait envenomation in Thailand

Tongpoo

Sriapha

Pradoo

et al. 2018

TCRM

View full text Add to dashboard Cite

show abstract

“…Another two cases were reported recently in literature [ 6 ]. A 25-year-old manual laborer presented with a Ceylon krait bite that had been provoked by contact of the foot.…”

Section: Discussionmentioning

confidence: 99%

“…It was used in 1993 for a confirmed case of Ceylon krait envenoming and the patient developed a severe anaphylactic reaction and died [ 5 ]. Another case of Ceylon krait bite with neuromuscular paralysis was administered anti-venom immediately following admission to which the patient developed a mild reaction and there was no prompt response following anti-venom, although the patient made a gradual but full recovery [ 6 ]. In our case the patient was given anti-venom immediately after admission.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Confirmed Ceylon krait (Bungarus ceylonicus) envenoming in Sri Lanka resulting in neuromuscular paralysis: a case report

Dalugama

Gawarammana

2017

J Med Case Reports

View full text Add to dashboard Cite

BackgroundCeylon krait (Bungarus ceylonicus) is a venomous elapid snake endemic to Sri Lanka. It inhabits shaded home gardens and forests in the wet zone of Sri Lanka and might creep into houses in the night. Despite frequent encounters with humans, reports of envenoming are very rare.Case presentationWe report a case of a 26-year-old Sri Lankan Sinhalese man with confirmed Ceylon krait envenoming presenting with bilateral partial ptosis, ophthalmoplegia, facial muscle weakness, and dysphagia. Single fiber electromyography and repetitive nerve stimulation confirmed neuromuscular paralysis. He was administered polyvalent anti-venom serum immediately following admission without a prompt clinical response. Complete recovery was observed 3 days following the bite.ConclusionsBecause of the rarity of envenoming, precise and detailed information on the clinical manifestations following envenoming is lacking. However, Ceylon krait bite can be potentially fatal; so, treating physicians should be aware of species identification, habitat, and biting habits and clinical presentation of envenoming of Ceylon krait. This case report adds knowledge to the existing limited literature available on Ceylon krait envenoming; a rare but potentially fatal clinical entity.

show abstract

Antivenin-naja/antivenin-bungarus/antivenin-daboia-russelli/antivenin-echis-coloratus

2017

Reactions Weekly

View full text Add to dashboard Cite

Two rare case reports of confirmed Ceylon krait (Bungarus ceylonicus) envenoming in Sri Lanka

Cited by 6 publications

References 10 publications

Krait envenomation in Thailand

Krait envenomation in Thailand

Confirmed Ceylon krait (Bungarus ceylonicus) envenoming in Sri Lanka resulting in neuromuscular paralysis: a case report

Antivenin-naja/antivenin-bungarus/antivenin-daboia-russelli/antivenin-echis-coloratus

Contact Info

Product

Resources

About