Intensive Care Unit, Teaching Hospital, Ratnapura, Sri Lanka; Department of Pharmacology, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Hidellana, Ratnapura, Sri Lanka; Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Sri Lanka.
Medical Unit, Teaching Hospital, Ratnapura, Sri Lanka.
Toxicon. 2021 Jul 30;198:143-150. doi: 10.1016/j.toxicon.2021.04.019. Epub 2021 May 3.
Ceylon krait (Bungarus ceylonicus) of the family Elapidae is a highly venomous endemic species inhabiting in the wet zone and some parts of the intermediate climatic zones of Sri Lanka. Clinical records of its bites are rare and limited to five case reports in the literature. It is of interest to note that there are several non-venomous snakes in Sri Lanka having similar morphological appearance to kraits causing identification difficulties which lead to unnecessary and unindicated administration of antivenom. We report two paediatric cases of proven Ceylon krait bites and three adult patients with similar looking non-venomous snakebites. These children were 1½ and 13 years old and developed neuroparalysis without progressing to respiratory failure and recovered. Both the children were administered Indian polyvalent antivenom which has not developed against endemic Ceylon krait venom. The two adult patients also received antivenom due to the misidentification without clinical and laboratory evidence of envenoming.
环蛇属的锡兰眼镜蛇（Bungarus ceylonicus）是一种高度有毒的特有物种，栖息在斯里兰卡的湿区和一些中间气候区。其咬伤的临床记录很少，文献中仅有五例病例报告。值得注意的是，斯里兰卡有几种无毒蛇与眼镜蛇外观相似，这给鉴别带来了困难，导致不必要和未指明的抗蛇毒血清的使用。我们报告了两例经证实的锡兰眼镜蛇咬伤的儿科病例和三例外观相似的无毒蛇咬伤的成年患者。这两个孩子分别为 1 岁半和 13 岁，出现神经瘫痪，但没有进展为呼吸衰竭并康复。两个孩子都接受了印度多价抗蛇毒血清治疗，而这种抗蛇毒血清并没有针对地方性的锡兰眼镜蛇毒液进行开发。另外两名成年患者也因未经临床和实验室证实的中毒而接受了抗蛇毒血清治疗，这是因为错误地将他们的咬伤识别为蛇咬伤。
