From the Research
According to the most recent and highest quality study, snake bite syndromes are categorized into neurotoxic, hemotoxic, cytotoxic, and mixed syndromes, with the most common being hemotoxic syndrome, which causes coagulopathy, bleeding, and sometimes renal failure, as seen in a study published in 2024 1. The main syndromes include:
- Neurotoxic syndrome, common with elapid bites (cobras, kraits), presents with descending paralysis starting with ptosis, ophthalmoplegia, and progressing to respiratory failure.
- Hemotoxic syndrome, seen with viper bites, causes coagulopathy, bleeding, and sometimes renal failure, as reported in a case study published in 2020 2.
- Cytotoxic syndrome involves local tissue damage, swelling, and necrosis, requiring antivenom, wound care, and possibly surgical debridement.
- Mixed syndromes show combinations of these effects. Treatment involves:
- Antivenom administration, with dosing based on severity rather than patient size.
- Supportive care, including airway management, fluid resuscitation, pain control, tetanus prophylaxis, and monitoring for complications like compartment syndrome or acute kidney injury, as reported in a study published in 2024 3.
- Antivenom reactions should be anticipated and treated promptly with adrenaline, antihistamines, and corticosteroids. It's worth noting that the incidence of acute kidney injury (AKI) is significant, with a study published in 2024 reporting an incidence of 29.1% 1, and that compartment syndrome is a rare but severe manifestation of snake bite, requiring prompt fasciotomy and antisnake venom administration, as reported in a case study published in 2024 3.