Management of ophidiotoxicosis caused by coral snakes

This case report presents an exceptional instance of envenomation following a physical altercation in which a coral snake was used as a whip. During the incident, the snake bit the patient's cheek, leading to envenomation. Within a few hours, he was hospitalised with sensory disturbances, weakness in the affected and adjacent regions, and nausea and vomiting. The snake was identified as an adult male Micrurus tener, also known locally as the 'coralillo' or 'harlequin coralillo'. Laboratory studies revealed leucocytosis, low haemoglobin concentration and an increase of creatine phosphokinase levels. Treatment consisted of analgesics, antibiotics and five vials of antivenom, consisting of F(ab')₂ fragments of polyvalent anticoral immunoglobulin. The patient recovered neurologically and was discharged without sequelae after 72 hours. The treatment was based on the pathophysiology of M. tener envenomation, with antivenom administration being the standard of care.