Citation

Khandelwal G, Katz KD, Brooks DE, Gonzalez SM, Ulishney CD. J. Emerg. Med. 2007; 32(2): 171-174.

Affiliation

Department of Emergency Medicine, University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, Pennsylvania 15213, USA.

Copyright

(Copyright © 2007, Elsevier Publishing)

DOI

10.1016/j.jemermed.2006.05.047

PMID

17307627

Abstract

Envenomation from cobra bites causes major morbidity and mortality in Asia and Africa but rarely in the United States. We describe two patients bitten by the Asiatic Cobra (Naja Kaouthia)--both successfully treated in the emergency department. Patient 1 was a 23-year-old woman bitten in the buttock by her cobra. Examination demonstrated two puncture wounds. She developed cranial neuropathy, respiratory failure, and coagulopathy 10 h later, necessitating endotracheal intubation and polyvalent antivenom administration. The patient recovered fully with minimal wound necrosis. Patient 2, a 44-year-old man, was bitten on the hand by his cobra. Examination revealed a puncture wound with progressive swelling. Edrophonium and monovalent antivenom were administered, and he recovered uneventfully. These cases emphasize the varied clinical presentations of the Asiatic cobra. Patient 1 developed delayed neurotoxicity, respiratory failure, and hematotoxicity with minimal wound necrosis, whereas Patient 2 experienced a more typical clinical course.

Language: en