Original Article

Texas Coral Snake (Micrurus tener) Bites

Authors: David L. Morgan, MD, Douglas J. Borys, PharmD, Rhandi Stanford, PharmD, Dean Kjar, BS, William Tobleman, MD

Abstract

Background: The clinical features of bites from Texas coral snakes (Micrurus tener) have not been well studied. Our goal was to review the largest number of victims of Texas coral snakebites to determine their characteristics, effects, treatment, and outcome.


Methods: Retrospective case series of Micrurus tener exposures reported to the Texas Poison Center Network from 2000 to 2004.


Results: Eighty-two patients were included in the analysis. Most (57.3%) were 18 to 49-year-old men. Almost 90% had local swelling, pain, erythema, or paresthesias. Only 7.3% had systemic effects, and none of these were severe. Over half received coral snake antivenin, and 15.9% were given opioids for pain. No patient died and no patient required mechanical ventilation due to hypoventilation from the snakebite.


Conclusions: There were more local findings and less severe systemic effects than previously reported. Antivenin is not needed for most of these patients, and opioids may be administered safely.


Key Points


* Only a few studies have described the clinical effects of coral snake bites in the US, and most of these were limited to the Eastern coral snake.


* Texas coral snake bites frequently produce local effects in many patients.


* Texas coral snakes bites rarely produce systemic findings. Texas coral snakes require antivenin only in the unlikely event of severe systemic effects.


* This study is limited by its retrospective nature and reliance on nonprofessional identification of the snake.

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