Received: May 22, 2008.

Accepted: September 10, 2008.

Abstract published online: September 18, 2008.

Full paper published online: November 30, 2008.

CONSECUTIVE BITES ON TWO PERSONS BY THE SAME COBRA: A CASE REPORT

AMIN MR (1), MAMUN SMH (2), CHOWDHURY NH (3), RAHMAN M (4), GHOSE A (5), AL HASAN A (6), FAIZ MA (7)

(1) Consultant of Medicine, Hathazari Upazilla Health Complex, Chittagong, Bangladesh; (2) Assistant Professor of Cardiology, Chittagong Medical College Hospital, Chittagong, Bangladesh; (3) Assistant Professor of Neuromedicine, Comilla Medical College, Comilla, Bangladesh; (4) Assistant Professor of Gastroenterology, Shahabuddin Medical College, Dhaka, Bangladesh; (5) Resident Medical Officer, Chittagong General Hospital, Chittagong, Bangladesh; (6) Consultant of Medicine, Meghna Health Complex, Comilla, Bangladesh; (7) Professor of Medicine, Dhaka Medical College, Dhaka, Bangladesh.

ABSTRACT: In tropical countries like Bangladesh, persons are bitten by snakes every day and a considerable number of patients die en route to the hospital. An event of consecutive neurotoxic bites on two men by a single snake was observed in the Snake Bite Study Clinic (SBSC) of the Chittagong Medical College Hospital (CMCH). Two brothers, working in their semi-pucca restaurant, were successively bitten by the same cobra on their lower limbs. Within an hour, they were taken to the CMCH. Few minutes after admission, both developed symptoms of neurotoxicity: ptosis, nasal voice, dysphagia, broken neck sign, etc. They received polyvalent antivenom (Haffkine Bio-Pharmaceuticals Company, India) and other auxiliary treatment immediately. Within few hours, neurotoxic features were completely absent. Later, the snake was captured in the restaurant kitchen and identified as monocellate cobra (Naja kauthia) by the SBSC. The elder brother developed significant antivenom reactions and both presented necrosis and ulceration at the bite sites. In these cases, immediate arrival to the hospital and early administration of antivenom resulted in successful recoveries.

KEY WORDS: consecutive bites, neurotoxicity, cobra, snakebite, antivenom.

CONFLICTS OF INTEREST: There is no conflict.

CORRESPONDENCE TO:

MOHAMMAD ROBED AMIN, Consultant of Medicine, Department of Medicine, Hathazari Upazilla Health Complex, Chittagong, Bangladesh, 28 R. C. Church Road, Patherghata, Chittagong, Bangladesh. Email: robedamin@yahoo.com.