Case history. “Coral snake” Micrurus mipartitus bite in 1968. A herpetologist's ordeal

Abstract

Historical clinical case that presented back in 1968 at a time when respiratory support and intensive care techniques were just emerging, with many shortcomings in hospital care areas and monitoring devices. The case is of a 58 year-old patient, outstanding citizen, recent winner in a television contest on snakes, who was bitten accidentally by a coral snake Micrurus mipartitus. The poison of this snake is a macromolecule that induces complete depolarizing muscle blockade which, if not reverted, leads to death from respiratory failure. A group of social leaders in the region managed to obtain the specific anti-venom that was not produced in the country, as well as the mechanical ventilation equipment, a negative pressure “iron lung” and a Bird Mark 7 positive pressure device. Manual ventilation was initiated by the anaesthesia team with the support of the medical students. Then, with the Bird Mark 7, the patient survived under empirical “intensive” care after 17 days of respiratory depression and 33 days in the hospital. Voluntary contributions of the community in an effort to solve the clinical problem are narrated.