Brown Snake Envenomation Clinical Presentation

Updated: Jun 15, 2018
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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The bites of Pseudonaja frequently occur on the extremities, mostly on the fingers and feet, because collectors handle them or people accidentally step on them. Unfortunately, unless the patient gives a history of being bitten by a snake, local clues to the evidence of a bite may be subtle or absent because brown snake bites cause little or no local swelling or pain. After giving a history of being bitten by a brown-colored snake, the patient may complain of neurological symptoms within an hour; the symptomatology within a few hours may manifest with a coagulopathy and signs of diaphragmatic paralysis and cardiovascular compromise. The following symptoms may be present:

  • Headache

  • Nausea and vomiting

  • Weakness

  • Photophobia

  • Irritability

  • Diplopia

  • Altered mental status

  • Dyspnea

  • Epistaxis

  • Gingival bleeding

  • Hematemesis

  • Hematochezia

  • Oliguria

  • Dysphagia


Physical Examination

Physical examination findings include the following:

  • Fang marks with coagulopathy

  • Little to no local edema or erythema

  • Bronchospasm

  • Ptosis

  • Trismus

  • Seizures

  • Respiratory muscle weakness to apnea

  • Cyanosis

  • Paralysis

  • Hypotension

  • Tachycardia or bradycardia

  • Cardiac arrest

  • Epistaxis

  • Hematemesis

  • Hematochezia

  • Petechia

  • Purpura

  • Cerebellar hemorrhage [6]



Complications may include the following: