학술논문

Optic Neuritis After a Snakebite: A Diagnostic Dilemma.
Document Type
Article
Source
Ochsner Journal. Mar2021, Vol. 21 Issue 1, p90-92. 3p.
Subject
*SNAKEBITES
*OPTIC neuritis
*POISONOUS snakes
*MEDICAL personnel
*CHOLINESTERASE inhibitors
*VIPERIDAE
Language
ISSN
1524-5012
Abstract
Background: Snakebite is one of themajor causes of morbidity and mortality in India, particularly in rural regions. Of the 57 known venomous species of snakes in India, the 4 most dangerous snakes are the cobra, the common krait, the Russell viper, and the sawscaled viper. Of these, the snakes commonly implicated with neurotoxicity are the cobra and the common krait--both elapidae. Acute neuromuscular weakness with respiratory system involvement is the most lethal neurotoxic effect. Case Report: A 24-year-old female was brought to the emergency department in an unresponsive state with a history of snakebite on the left foot. The patientwas intubated, mechanically ventilated, and promptly started on snake antivenom and anticholinesterase agents. The patient improved significantly and was extubated. On day 6, she developed blurred vision and slurred speech. She was diagnosed with bilateral optic neuropathy and treated with repeat snake antivenom and steroids. She improved significantly and was discharged on day 14. Conclusion: When a person is bitten by a venomous snake, antivenom is the mainstay of treatment, but clinicians must also consider possible reactions and complications. Optic neuritis following a snakebite is rare but does occur. The prognosis is generally good if clinical suspicion for such a complication is strong, the snake is identified, and the patient receives timely treatment with steroids. [ABSTRACT FROM AUTHOR]