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Paralysis and Necrotic Wound Infection Resulting From Monocled Cobra Envenomation
Danielle A Sultan1, George Angelakakis1, Matthew C Braun2
1Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Allentown, USA.
Cureus
|December 3, 2024
Summary
Managing non-native snake envenomations is challenging due to antivenom access and unfamiliarity. This case highlights the need for expert consultation in treating exotic snakebites and their complications.
Area of Science:
- Toxicology
- Herpetology
Background:
- Non-native snake envenomations present unique management challenges.
- Access to appropriate antivenom and familiarity with clinical effects are often limited.
Observation:
- A 37-year-old male was envenomated by a pet monocled cobra (Naja kaouthia).
- The patient developed respiratory failure requiring mechanical ventilation.
- Secondary wound infection with Morganella morganii and Enterococcus faecalis occurred post-treatment.
Findings:
- Thai king cobra antivenom was administered following expert consultation.
- The patient required surgical intervention including debridement, fasciotomy, and skin grafting for wound complications.
- Full functional recovery was achieved 36 days post-envenomation.
Implications:
- This case underscores the difficulties in managing exotic snakebites.
- Medical toxicologists and poison control centers are crucial resources for antivenom sourcing and treatment guidance.
- Prompt identification and management of secondary infections are vital for patient outcomes.
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