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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MDPI AG
2022-11-01
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| author | Subramanian Senthilkumaran Stephen W. Miller Harry F. Williams Ponniah Thirumalaikolundusubramanian Ketan Patel Sakthivel Vaiyapuri |
| author_facet | Subramanian Senthilkumaran Stephen W. Miller Harry F. Williams Ponniah Thirumalaikolundusubramanian Ketan Patel Sakthivel Vaiyapuri |
| author_sort | Subramanian Senthilkumaran |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T17:57:42Z |
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| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-09T17:57:42Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
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| series | Toxins |
| spelling | doaj.art-f8413c8e6d504895a13457516bba4da22023-11-24T10:15:30ZengMDPI AGToxins2072-66512022-11-01141180510.3390/toxins14110805Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common KraitSubramanian Senthilkumaran0Stephen W. Miller1Harry F. Williams2Ponniah Thirumalaikolundusubramanian3Ketan Patel4Sakthivel Vaiyapuri5Manian Medical Centre, Erode 638001, Tamil Nadu, IndiaThe Poison Control Center, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USAToxiven Biotech Private Limited, Coimbatore 641042, Tamil Nadu, IndiaDepartment of General Medicine, The Tamil Nadu Dr M.G.R Medical University, Chennai 600032, Tamil Nadu, IndiaSchool of Biological Sciences, University of Reading, Reading RG6 6UB, UKSchool of Pharmacy, University of Reading, Reading RG6 6UB, UKIn 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.https://www.mdpi.com/2072-6651/14/11/805snakebite envenomationIndian cobracommon kraitoptic neuritiscorticosteroids |
| spellingShingle | Subramanian Senthilkumaran Stephen W. Miller Harry F. Williams Ponniah Thirumalaikolundusubramanian Ketan Patel Sakthivel Vaiyapuri Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait Toxins snakebite envenomation Indian cobra common krait optic neuritis corticosteroids |
| 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 | snakebite envenomation Indian cobra common krait optic neuritis corticosteroids |
| url | https://www.mdpi.com/2072-6651/14/11/805 |
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