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Myocarditis and severe neuromuscular paralysis following a suspected Common krait (Bungarus caeruleus) envenoming in a child: A case report

Authors:

Givani Amarakoon,

Rajarata University of Sri Lanka, LK
About Givani
Department of Paediatrics, Faculty of Medicine and Allied Sciences
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Supun Wedasingha,

Rajarata University of Sri Lanka, LK
About Supun
Department of Pharmacology, Faculty of Medicine and Allied Sciences
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Isuru Sandakelum,

Teaching Hospital, Anuradhapura, LK
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Janith Chandrakumara,

Rajarata University of Sri Lanka, LK
About Janith
Department of Paediatrics, Faculty of Medicine and Allied Sciences
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Anjana Silva

Faculty of Medicine and Allied Sciences, LK
About Anjana

Department of Parasitology, Faculty of Medicine and Allied Sciences

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Abstract

Common krait (Bungarus caeruleus) bites cause significant morbidity and mortality in South Asia. Neurotoxicity is the most important clinical entity associated with common krait envenoming and cardiac effects are only rarely observed.

 

We report a case of a two-year-and ten months old Sri Lankan child who developed myocarditis and severe neuromuscular paralysis following a suspected common krait bite. ECG, echocardiographic changes, and elevation of cardiac troponins as well as creatinine kinase were highly suggestive of myocarditis. With polyvalent anti-venom serum and heart failure standard treatment, the child gradually improved. Complete recovery of cardiac functions was seen within 10 days from the bite.

 

This unique feature of common krait envenoming may be related to the differences in the pharmacokinetics of snake venom in children compared to adults.

How to Cite: Amarakoon, G., Wedasingha, S., Sandakelum, I., Chandrakumara, J. and Silva, A., 2022. Myocarditis and severe neuromuscular paralysis following a suspected Common krait (Bungarus caeruleus) envenoming in a child: A case report. Anuradhapura Medical Journal, 16(1), pp.26–30. DOI: http://doi.org/10.4038/amj.v16i1.7713
Published on 23 Mar 2022.
Peer Reviewed

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