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Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait

In India, most snakebite envenomation (SBE) incidents are caused by the “Big Four” snakes which include Russell’s viper, common krait, Indian cobra, and saw-scaled viper. Their common envenomation effects include neurotoxicity, myotoxicity, and coagulopathy. However, they also induce rare complicati...

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Autores principales: Senthilkumaran, Subramanian, Miller, Stephen W., Williams, Harry F., Thirumalaikolundusubramanian, Ponniah, Patel, Ketan, Vaiyapuri, Sakthivel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697512/
https://www.ncbi.nlm.nih.gov/pubmed/36422979
http://dx.doi.org/10.3390/toxins14110805
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author Senthilkumaran, Subramanian
Miller, Stephen W.
Williams, Harry F.
Thirumalaikolundusubramanian, Ponniah
Patel, Ketan
Vaiyapuri, Sakthivel
author_facet Senthilkumaran, Subramanian
Miller, Stephen W.
Williams, Harry F.
Thirumalaikolundusubramanian, Ponniah
Patel, Ketan
Vaiyapuri, Sakthivel
author_sort Senthilkumaran, Subramanian
collection PubMed
description In India, most snakebite envenomation (SBE) incidents are caused by the “Big Four” snakes which include Russell’s viper, common krait, Indian cobra, and saw-scaled viper. Their common envenomation effects include neurotoxicity, myotoxicity, and coagulopathy. However, they also induce rare complications such as priapism, pseudoaneurysm, and sialolithiasis. Ocular manifestations such as optic neuritis develop rarely following envenomations by non-spitting snakes and they may cause temporary vision changes and blindness if untreated. While optic neuritis following Indian cobra envenomation has been reported previously, this was not encountered in victims of common kraits. Hence, for the first time, we report optic neuritis developed in a victim following envenomation by a common krait and compare its clinical features and diagnostic and therapeutic methods used with another case of optic neuritis in a victim of an Indian cobra bite. Both patients received antivenom treatment and made an initial recovery; however, optic neuritis developed several days later. The condition was diagnosed using ophthalmic examination together with computed tomography and/or magnetic resonance imaging methods. Due to very similar clinical features, both patients received intravenous corticosteroids which restored their vision and successfully treated optic neuritis. This case report suggests that the optic neuritis developed in a common krait envenomation is comparable to the one developed following a cobra bite, and therefore, the same diagnostic and therapeutic approaches can be used. This study also raises awareness of this rare complication and provides guidance for the diagnosis and treatment of SBE-induced optic neuritis.
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spelling pubmed-96975122022-11-26 Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait Senthilkumaran, Subramanian Miller, Stephen W. Williams, Harry F. Thirumalaikolundusubramanian, Ponniah Patel, Ketan Vaiyapuri, Sakthivel Toxins (Basel) Case Report In India, most snakebite envenomation (SBE) incidents are caused by the “Big Four” snakes which include Russell’s viper, common krait, Indian cobra, and saw-scaled viper. Their common envenomation effects include neurotoxicity, myotoxicity, and coagulopathy. However, they also induce rare complications such as priapism, pseudoaneurysm, and sialolithiasis. Ocular manifestations such as optic neuritis develop rarely following envenomations by non-spitting snakes and they may cause temporary vision changes and blindness if untreated. While optic neuritis following Indian cobra envenomation has been reported previously, this was not encountered in victims of common kraits. Hence, for the first time, we report optic neuritis developed in a victim following envenomation by a common krait and compare its clinical features and diagnostic and therapeutic methods used with another case of optic neuritis in a victim of an Indian cobra bite. Both patients received antivenom treatment and made an initial recovery; however, optic neuritis developed several days later. The condition was diagnosed using ophthalmic examination together with computed tomography and/or magnetic resonance imaging methods. Due to very similar clinical features, both patients received intravenous corticosteroids which restored their vision and successfully treated optic neuritis. This case report suggests that the optic neuritis developed in a common krait envenomation is comparable to the one developed following a cobra bite, and therefore, the same diagnostic and therapeutic approaches can be used. This study also raises awareness of this rare complication and provides guidance for the diagnosis and treatment of SBE-induced optic neuritis. MDPI 2022-11-19 /pmc/articles/PMC9697512/ /pubmed/36422979 http://dx.doi.org/10.3390/toxins14110805 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Senthilkumaran, Subramanian
Miller, Stephen W.
Williams, Harry F.
Thirumalaikolundusubramanian, Ponniah
Patel, Ketan
Vaiyapuri, Sakthivel
Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait
title Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait
title_full Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait
title_fullStr Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait
title_full_unstemmed Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait
title_short Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait
title_sort bilateral simultaneous optic neuritis following envenomations by indian cobra and common krait
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697512/
https://www.ncbi.nlm.nih.gov/pubmed/36422979
http://dx.doi.org/10.3390/toxins14110805
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