Coral snake envenomation
Coral snake venom is neurotoxic. Neuromuscular dysfunction with respiratory or cardiovascular failure may occur with envenomation.
Coral snakes are shy, and bites are uncommon. In the United States, there are fewer than 20 bites per year (approximately 1% of all snake bites) and no deaths have been reported since coral snake antivenom became available. Most bites (up to 60%) are "dry" bites (no envenomation) because coral snakes must chew the victim's tissue for a brief period to achieve significant envenomation. Victims of coral snake bites typically have intentionally interacted with the snake.
The bite site may reveal multiple small puncture wounds with minimal soft tissue swelling. The victim may complain of mild pain, localized numbness, or paresthesias.
Systemic symptoms, predominately neurological, dominate the clinical picture. With significant envenomation, the onset of symptoms may be delayed up to 10-12 hours but may then rapidly progress. Altered mental status is the earliest symptom. Cranial nerve dysfunction followed by generalized weakness, peripheral paralysis, respiratory failure, and cardiovascular collapse may result.
T63.021A – Toxic effect of coral snake venom, accidental, initial encounter
217653004 – Poisoning due to coral snake venom
Differential Diagnosis & Pitfalls