Ophitoxemia (Snakebite Envenomation)
Forensic Toxicology: Clinical Manifestations
1. Clinical Classification
Toxicity is primarily determined by the venom composition: Neurotoxic (e.g., Cobra, Krait) or Hemotoxic/Cytotoxic (e.g., Viper).
2. Comparative Signs and Symptoms
| Type | Clinical Features |
|---|---|
| Neurotoxic | Ptosis (early sign), ophthalmoplegia, dysphagia, respiratory paralysis, and limb weakness. |
| Hemotoxic | Bleeding diathesis (epistaxis, hematuria, gingival bleeding), coagulopathy. |
| Cytotoxic | Severe local pain, edema, blistering, necrosis, and regional lymphadenopathy. |
3. Forensic High-Yield Pearls
- Fang Marks: Presence of two distinct puncture wounds is suggestive of an elapid or viperid bite, though multiple or absent marks do not rule out envenomation.
- 20-Minute Whole Blood Clotting Test (20WBCT): A bedside screening test for hemotoxic snakebites; failure to clot indicates significant systemic coagulopathy.
- Management: Rapid administration of Polyvalent Antivenom is the only definitive treatment for systemic envenomation.
- Educational Resource: For detailed envenomation protocols and forensic toxicology questions, visit mymedschool.org.