Snakebite Clinical Effects

Table 2.1.2 Clinical effects of Australian Elapidae snakes

Category  (Genus)Venom-induced consumptive coagulopathyNeurotoxicity

(Pre-synaptic)

Neurotoxicity

(post-synaptic)

RhabdomyolysisRenal failureOther effects
Brown (Pseudonaja)Always present with significant envenomingVery rareNot presentNot presentUncommon

Primary mechanism poorly understood

Microangiopathic haemolytic anaemia and thrombocytopenia
Tiger (Notechis)Always present with significant envenoming

May resolve spontaneously in 12-24 hours

Slow onset over hours (possibly up to 12-24 hours)Not presentSlow onset over hours

May be severe and result in renal failure

Uncommon

Primary mechanism poorly understood

May also occur secondary to rhabdomyolysis

Microangiopathic haemolytic anaemia and thrombocytopenia
Death adders (Acanthophis)Not presentNot presentSlow onset over hours (possibly up to 12-24 hours)Not presentNot presentLocal bite site pain often present
Black (Pseudechis)Not present

Mild anticoagulant effect may be seen with raised aPTT

Fibrinogen remains normal

Not presentNot presentMay develop over hours to days

May be severe and result in renal failure

Secondary to rhabdomyolysisBite site pain may be significant

Envenoming usually associated with nausea, vomiting, abdominal pain and headache

Taipan (Oxyuranus)Always present with significant envenomingMay be rapid in onsetNot presentMay develop over minutes to hoursUncommon

Primary mechanism poorly understood

May occur secondary to rhabdomyolysis

Microangiopathic haemolytic anaemia and thrombocytopenia
Sea snakes

(Hydrophiidae)

Not presentMay be rapid in onsetNot presentMay develop over minutes to hoursSecondary to rhabdomyolysis

Toxicology Handbook

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About Mike Cadogan

Emergency physician with a passion for medical informatics and medical education. Co-founder of HealthEngine, iMeducate, and the GMEP. He writes more eclectically on the web as @sandnsurf | + Mike Cadogan | Contact