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Optic Neuritis After a Snakebite: A Diagnostic Dilemma
Jeyhan Dhabhar1, Varshil Mehta2, Nimit Desai3
1Department of Internal Medicine, MGM Medical College, Navi Mumbai, India.
Ochsner Journal
|April 8, 2021
Summary
Snakebite envenoming in India can cause severe neurotoxicity. This case highlights optic neuropathy as a rare complication, emphasizing prompt diagnosis and treatment with antivenom and steroids for a good prognosis.
Area of Science:
- Neurology
- Toxicology
- Ophthalmology
Background:
- Snakebite envenoming is a significant public health issue in India, leading to considerable morbidity and mortality, especially in rural areas.
- Elapidae snakes, including the cobra and common krait, are primarily responsible for neurotoxic effects, often resulting in acute neuromuscular weakness and respiratory compromise.
Observation:
- A 24-year-old female presented with unresponsiveness after a snakebite, requiring intubation and mechanical ventilation.
- Following initial improvement with antivenom and anticholinesterase agents, the patient developed blurred vision and slurred speech on day 6, indicative of bilateral optic neuropathy.
Findings:
- The patient was treated with repeat snake antivenom and steroids for optic neuritis, leading to significant clinical improvement.
- Discharge occurred on day 14, demonstrating the efficacy of timely and comprehensive management for this rare snakebite complication.
Implications:
- While antivenom is crucial for snakebite management, clinicians must remain vigilant for potential neurological and ophthalmological complications.
- Optic neuritis following snakebite, though uncommon, necessitates early recognition and aggressive treatment with steroids and antivenom for favorable outcomes.
- This case underscores the importance of identifying the snake species and considering rare adverse events in the clinical suspicion and management of snakebite victims.
