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Acute neuromuscular paralysis, rhabdomyolysis and long lasting neurological deficits in Ceylon krait (Bungarus ceylonicus) bites: Two authentic cases from a serpentarium in Sri Lanka.
Toxicon X. 2019 Oct; 4:100015.TX

Abstract

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.

Authors+Show Affiliations

Department of Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka.Teaching Hospital Peradeniya, Sri Lanka.15/1, Dolosbage Road, Gampola, Sri Lanka.Teaching Hospital Peradeniya, Sri Lanka. Department of Physiology, Faculty of Medicine, University of Peradeniya, Sri Lanka.Intensive Care Unit, Teaching Hospital, Ratnapura, Sri Lanka. Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Sri Lanka. Postgraduate Institute of Medicine (Clinical Pharmacology and Therapeutics), University of Colombo, Sri Lanka.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32550572

Citation

Kularatne, S A M., et al. "Acute Neuromuscular Paralysis, Rhabdomyolysis and Long Lasting Neurological Deficits in Ceylon Krait (Bungarus Ceylonicus) Bites: Two Authentic Cases From a Serpentarium in Sri Lanka." Toxicon: X, vol. 4, 2019, p. 100015.
Kularatne SAM, Colombage A, de Silva A, et al. Acute neuromuscular paralysis, rhabdomyolysis and long lasting neurological deficits in Ceylon krait (Bungarus ceylonicus) bites: Two authentic cases from a serpentarium in Sri Lanka. Toxicon X. 2019;4:100015.
Kularatne, S. A. M., Colombage, A., de Silva, A., Weerasinghe, V., & Rathnayaka, R. M. M. K. N. (2019). Acute neuromuscular paralysis, rhabdomyolysis and long lasting neurological deficits in Ceylon krait (Bungarus ceylonicus) bites: Two authentic cases from a serpentarium in Sri Lanka. Toxicon: X, 4, 100015. https://doi.org/10.1016/j.toxcx.2019.100015
Kularatne SAM, et al. Acute Neuromuscular Paralysis, Rhabdomyolysis and Long Lasting Neurological Deficits in Ceylon Krait (Bungarus Ceylonicus) Bites: Two Authentic Cases From a Serpentarium in Sri Lanka. Toxicon X. 2019;4:100015. PubMed PMID: 32550572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute neuromuscular paralysis, rhabdomyolysis and long lasting neurological deficits in Ceylon krait (Bungarus ceylonicus) bites: Two authentic cases from a serpentarium in Sri Lanka. AU - Kularatne,S A M, AU - Colombage,Anuradha, AU - de Silva,Anslem, AU - Weerasinghe,Vajira, AU - Rathnayaka,R M M K Namal, Y1 - 2019/10/02/ PY - 2019/07/25/received PY - 2019/08/26/revised PY - 2019/09/12/accepted PY - 2020/6/19/entrez PY - 2020/6/19/pubmed PY - 2020/6/19/medline KW - Bungarus ceylonicus KW - Ceylon krait KW - Neuroparalysis KW - Snakebites KW - Sri Lanka SP - 100015 EP - 100015 JF - Toxicon: X JO - Toxicon X VL - 4 N2 - 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. SN - 2590-1710 UR - https://www.unboundmedicine.com/medline/citation/32550572/Acute_neuromuscular_paralysis,_rhabdomyolysis_and_long_lasting_neurological_deficits_in_Ceylon_krait_(Bungarus_ceylonicus)_bites:_Two_authentic_cases_from_a_serpentarium_in_Sri_Lanka L2 - https://linkinghub.elsevier.com/retrieve/pii/S2590-1710(19)30012-8 DB - PRIME DP - Unbound Medicine ER -
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