Brown Snake Envenomation Clinical Presentation

Updated: May 12, 2017
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Presentation

History

The bites of Pseudonaja frequently occur on the extremities, mostly on the fingers and feet, because collectors handle them or people accidentally step on them. Unfortunately, unless the patient gives a history of being bitten by a snake, local clues to the evidence of a bite may be subtle or absent because brown snake bites cause little or no local swelling or pain. After giving a history of being bitten by a brown-colored snake, the patient may complain of neurological symptoms within an hour; the symptomatology within a few hours may manifest with a coagulopathy and signs of diaphragmatic paralysis and cardiovascular compromise. The following symptoms may be present:

  • Headache
  • Nausea and vomiting
  • Weakness
  • Photophobia
  • Irritability
  • Diplopia
  • Altered mental status
  • Dyspnea
  • Epistaxis
  • Gingival bleeding
  • Hematemesis
  • Hematochezia
  • Oliguria
  • Dysphagia
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Physical Examination

Physical examination findings include the following:

  • Fang marks with coagulopathy
  • Little to no local edema or erythema
  • Bronchospasm
  • Ptosis
  • Trismus
  • Seizures
  • Respiratory muscle weakness to apnea
  • Cyanosis
  • Paralysis
  • Hypotension
  • Tachycardia or bradycardia
  • Cardiac arrest
  • Epistaxis
  • Hematemesis
  • Hematochezia
  • Petechia
  • Purpura
  • Cerebellar hemorrhage [6]
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Complications

Complications may include the following:

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