Evenoming by Bungarus multicinctus (many-banded krait) in Hong Kong

We describe the clinical course of two cases of envenoming by the many-banded krait (Bungarus multicinctus). A man developed generalized paralysis and respiratory failure with transient hypertension. Nerve conduction studies revealed normal motor and sensory conduction velocities with reduced motor unit action potential amplitudes consistent with neuromuscular blockade. He showed a slight transient response to the banded krait (B. fasciatus) antivenom but required ventilatory support for 8 days. After the fourth day, there was some response to treatment with anticholinesterase. Another man developed diplopia, dysphagia and leg weakness but recovered spontaneously after 48 hours.