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First reported case of systemic envenoming by the Sri Lankan keelback (Balanophis ceylonensis)
- Fernando, W.K.B.K.M., Kularatne, S.A.M., Wathudura, S.P.K., de Silva, A., Mori, A., Mahaulpatha, D.
- Toxicon 2015 v.93 pp. 20-23
- consciousness, electroencephalography, headache, hospitals, males, photography, snakes, venoms, Sri Lanka
- Envenoming by colubrid snakes is rarely reported. However, some colubrid snakes (e.g. Rhabdophis tigrinus and Rhabdophis subminiatus) have caused severe systemic envenoming. We report here the first case of a bite with systemic envenoming by Balanophis ceylonensis, an opisthoglyphous natricine colubrid, in Sri Lanka. A 33-year-old healthy male field biologist was bitten while handling the snake for photography. Within 5 min of the bite on the dorsum of the right hand, he reported severe occipital headache, photophobia, chills and transient loss of consciousness. He vomited blood-stained gastric contents and bled from venepuncture sites. He had a markedly elevated INR and positive D-dimer test suggestive of significant coagulopathy that was treated with infusions of fresh frozen plasma. He recovered and left hospital after 96 h and subsequent investigations, including electroencephalogram, were normal. We conclude that B. ceylonensis should be regarded as a medically significant venomous snake. This case highlights the need for further studies of the oral secretions (venoms) of colubrid snakes.