Abstract
Background: Snakebite is one of the major causes of morbidity and mortality in India, particularly in rural regions. Of the 57 known venomous species of snakes in India, the 4 most dangerous snakes are the cobra, the common krait, the Russell viper, and the saw-scaled viper. Of these, the snakes commonly implicated with neurotoxicity are the cobra and the common krait—both elapidae. Acute neuromuscular weakness with respiratory system involvement is the most lethal neurotoxic effect.Case Report: A 24-year-old female was brought to the emergency department in an unresponsive state with a history of snakebite on the left foot. The patient was intubated, mechanically ventilated, and promptly started on snake antivenom and anticholinesterase agents. The patient improved significantly and was extubated. On day 6, she developed blurred vision and slurred speech. She was diagnosed with bilateral optic neuropathy and treated with repeat snake antivenom and steroids. She improved significantly and was discharged on day 14.Conclusion: When a person is bitten by a venomous snake, antivenom is the mainstay of treatment, but clinicians must also consider possible reactions and complications. Optic neuritis following a snakebite is rare but does occur. The prognosis is generally good if clinical suspicion for such a complication is strong, the snake is identified, and the patient receives timely treatment with steroids.
Highlights
In India, a developing country where the principal occupation is agriculture, snakes and other reptiles form an important part of the ecosystem
We describe the case of a 24year-old female who presented with snakebite from an Indian cobra
We found only 7 case reports of optic neuritis following snakebite.[6,7,8,9,10,11,12]
Summary
Snakebite is one of the major causes of morbidity and mortality in India, in rural regions. Of the 57 known venomous species of snakes in India, the 4 most dangerous snakes are the cobra, the common krait, the Russell viper, and the sawscaled viper. The snakes commonly implicated with neurotoxicity are the cobra and the common krait—both elapidae. On day 6, she developed blurred vision and slurred speech. She was diagnosed with bilateral optic neuropathy and treated with repeat snake antivenom and steroids. She improved significantly and was discharged on day 14. The prognosis is generally good if clinical suspicion for such a complication is strong, the snake is identified, and the patient receives timely treatment with steroids
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