Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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A Case of Cobra Antivenom Therapy in a Patient Bitten by Elapid Snake in South Korea

코브라과 뱀에 물린 환자에서 코브라 항독소를 사용하여 치료한 1례

  • Kim, Ji Eun (Department of Emergency Medicine, College of Medicine, Dong-A University) ;
  • Kwon, In Ho (Department of Emergency Medicine, College of Medicine, Dong-A University)
  • 김지은 (동아대학교병원 응급의학과) ;
  • 권인호 (동아대학교병원 응급의학과)
  • Received : 2022.01.22
  • Accepted : 2022.03.02
  • Published : 2022.06.30
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Abstract

Elapid snakes have neurotoxic venom which causes diverse neuroparalytic manifestations, including fatal respiratory failure. In South Korea, since elapid snakebites are very rare, the cobra antivenom, which is effective against neurotoxicity, was only introduced recently. Most physicians in South Korea have little experience in the treatment of patients who have been bitten by elapid snakes. A 19-year-old man was brought to the emergency department with sudden diplopia, 1 hour after a snakebite on the left 2nd finger. The patient presented with drowsiness and complained of mild dizziness and binocular diplopia. After 1 hour, he had sudden onset of dyspnea and dysphagia and appeared to be agitated. He was immediately intubated and received mechanical ventilation as he was unable to breathe on his own. A total of 2.5 mg of neostigmine diluted with normal saline was slowly infused, and 1 vial of cobra antivenom was infused for an hour, 5 times every 2 hours, for a total of 5 vials. He slowly recovered self-breathing; on the 3rd day of hospitalization, he showed tolerable breathing and was extubated. He was discharged without any neurological deficits or other complications.

Keywords

Acknowledgement

The authors would like to thank the National Medical Center for providing cobra antivenom.

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