Coral snake bite (Micrurus altirostris)

First case in Uruguay

Abstract

Micrurus snakebites are rather unusual globally. In Uruguay, poisoning cases are exclusively caused by Bothrops alternatus and B. pubescens (“crucera” and “yarará” - crossed pit viper). Reporting poisoning to the Poison Information and Advice Service is mandatory since 1986, there being no cases reported of Micrurus altirostris bites until this clinical report. This study presents the first clinical case of coral snake bite (Micrurus altirostris) in our country, emphasizing its severity given the neurotoxicity that evolved into respiratory paralysis requiring invasive mechanical ventilation. Life support implemented resulted in a good evolution, no neostigmine being required, extubation and complete reversal of the clinical symptoms being achieved after four days. Availability of the poisoning antidote (antielapidic serum) is limited around the world, and it cannot be found in our country. Thus, in severe cases, in particular with respiratory failure, mechanical ventilation is the main therapeutic pillar.