Krait envenomation in Thailand

Area of Science:

• * Clinical Toxicology
• * Herpetology
• * Neurotoxicology

Background:

• * Thailand has three *Bungarus* species, with *Bungarus candidus* (Malayan krait) being the most common and lethal.
• * Limited data exists on the clinical outcomes of *Bungarus fasciatus* (banded krait) envenomation.

Purpose of the Study:

• * To investigate the clinical manifestations and outcomes of krait envenomation in Thailand.
• * To provide insights into the specific effects of *Bungarus* species bites.

Main Methods:

• * Retrospective analysis of krait envenomation cases over a 9-year period.
• * Data sourced from the Ramathibodi Poison Center Toxic Exposure Surveillance System.

Main Results:

• * 78 cases analyzed; most patients were male (59.0%), median age 28.
• * Minimal local effects; neurological manifestations appeared within 3 hours.
• * Common systemic effects included hypertension (67.4%), tachycardia (61.7%), hypokalemia (55.3%), and hyponatremia (17.6%).
• * Mortality rate was 6.4%, exclusively from *B. candidus* bites; 75.6% required mechanical ventilation.
• * Pneumonia was a common complication, significantly associated with mortality.

Conclusions:

• * Krait bites, particularly Malayan krait, present a high mortality risk despite minimal local symptoms.
• * Frequent monitoring of vital signs and electrolytes is essential.
• * Supportive care and complication management are critical for improving outcomes in krait envenomation.