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Emerg Med Clin North Am 2022 May;40(2):313-326

Department of Medical Toxicology, Banner University Medical Center Phoenix, 1012 East Willetta Street, Fl 2, Phoenix, AZ 85006, USA; University of Arizona College of Medicine, Phoenix, AZ, USA.

This review discusses the distinct envenomation syndromes produced by North American species of snakes and arthropods, specifically the Crotalinae subfamily of snakes, which includes cottonmouths, copperheads, and rattlesnakes; coral snakes; Latrodectus and Loxosceles species of arachnid; and Centruroides sculpturatus, the only species of North American scorpion capable of producing an envenomation syndrome. The authors discuss the epidemiology, pathophysiology, and presentation of these syndromes and emphasize the varying degrees to which these syndromes can manifest clinically. Finally, the management of each envenomation syndrome is addressed. Read More

Toxins (Basel) 2022 Apr 9;14(4). Epub 2022 Apr 9.

Grupo de Investigación en Toxinología, Alternativas Terapéuticas y Alimentarias, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellin 1226, Colombia.

In Colombia, the genus includes 30 species, of which and are the most widely distributed. causes less than 3% of the approximately 5000 cases of snakebite per year. The elapid envenomation caused by the snakes from the genus, are characterized by the severity of their clinical manifestations, due to the venom neurotoxic components such as three-finger toxins (3FTx) and phospholipases (PLA). Read More

Biomedica 2021 12 15;41(4):631-642. Epub 2021 Dec 15.

Grupo de Nutrición, Facultad de Salud, Universidad del Valle, Cali, Colombia.

We report two snakebites by Micrurus ortoni in Colombia and one by M. hemprichii in Perú. In two of the cases, we observed mild to moderate motor neurological involvement and in all patients, there was a marked sensory effect with hyperesthesia and hyperalgesia radiating from the bite site to the entire ipsilateral hemibody. Read More

Toxicol Lett 2022 Mar 10;356:54-63. Epub 2021 Nov 10.

Laboratory of Toxinology and Cardiovascular Research, Graduate Program in Health Sciences, University of Western São Paulo (UNOESTE), Rodovia Raposo Tavares Km 572, B2-205, 19067-175, Presidente Prudente, SP, Brazil; Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, G4 0RE, Glasgow, UK. Electronic address:

In this study, we investigated the action of varespladib (VPL) alone or in combination with a coral snake antivenom (CAV) on the local and systemic effects induced by Micrurus corallinus venom in rats. Adult male Wistar rats were exposed to venom (1.5 mg/kg - i. Read More

J Venom Anim Toxins Incl Trop Dis 2021 24;27:e20210024. Epub 2021 Sep 24.

Venom Research and Toxicology Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya. Kuala Lumpur, Malaysia.

Background: The Malayan blue coral snake, , is a medically important venomous snake in Southeast Asia. However, the complexity and diversity of its venom genes remain little explored.

Methods: To address this, we applied high-throughput next-generation sequencing to profile the venom gland cDNA libraries of . Read More

Toxicon 2021 09 23;200:153-164. Epub 2021 Jul 23.

Instituto de Biotecnología de la Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico.

We developed experimental equine polyvalent and monovalent antivenoms against the venoms of Micrurus (M.) fulvius, M. nigrocinctus and M. Read More

BMJ Case Rep 2021 Mar 25;14(3). Epub 2021 Mar 25.

Medicine, University of the West Indies at Saint Augustine, Saint Augustine, Tunapuna-Piarco, Trinidad and Tobago.

Cardiovasc Toxicol 2021 06 9;21(6):462-471. Epub 2021 Feb 9.

Departamento de Clínica e Cirurgia Veterinárias, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Micrurus surinamensis is a coral snake from the Elapidae family of wide distribution in Amazonia Forest. Its venom contains neurotoxins that induce muscular and respiratory paralysis; however, its cardiovascular action is not yet characterized. The aim of this study was to investigate the cardiotoxic effects caused by M. Read More

Biochimie 2021 Mar 21;182:206-216. Epub 2021 Jan 21.

Instituto de Biotecnología, Universidad Nacional Autónoma de México, Av. Universidad # 2001, Colonia Chamilpa, CP: 62210, Cuernavaca, Morelos, Mexico. Electronic address:

The elapid genus, Micruroides, is considered the sister clade of all New World coral snakes (Genus Micrurus), is monotypic, and is represented by Sonoran Coral Snakes, Micruroides euryxanthus. Coral snakes of the genus Micrurus have been reported to have venoms that are predominantly composed of phospholipases A (PLA) or three finger toxins (3FTx), but the venoms of the genus Micruroides are almost completely unstudied. Here, we present the first description of the venom of M. Read More

Vaccine 2021 02 8;39(6):1000-1006. Epub 2021 Jan 8.

Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología - UNAM, Av. Universidad 2001, Cuernavaca, Morelos 62210, Mexico. Electronic address:

Background: Micrurus venoms contain two main groups of toxic protein components: short-chain α-neurotoxins (SNtx) and phospholipases type A (PLA). In North America, generally, the Micrurus venoms have low abundance of SNtx compared to that of PLAs; however, both are highly toxic to mammals, and consequently both can play a major role in the envenomation processes. Concerning the commercial horse-derived antivenoms against Micrurus from the North America region, they contain a relatively large amount of antibodies against PLAs, and a low content of antibodies against short chain α-neurotoxins. Read More

Toxicon 2021 Feb 13;191:38-43. Epub 2020 Dec 13.

University of Florida Small Animal Hospital, 2089 Southwest 16th Avenue, Gainesville, FL, 32608, United States. Electronic address:

Thirty cats were identified to be have been suspected to have a potential coral snake envenomation after searching medical records from 2012 to 2019 at a university teaching hospital. The records were reviewed and evaluated for signalment, date and time of the snake encounter, elapsed time between encounter and hospital examination, presenting complaint, initial physical examination findings, initial laboratory findings, antivenom dose and duration of administration, adverse reactions to antivenom, additional treatments administered, progression of clinical signs, length of hospitalization, and outcome. Thirteen cats presented with clinical signs consistent with envenomation while 17 cats were treated for possible asymptomatic envenomation, as defined by the owner discovering a live or dead coral snake in their home or on their property. Read More

Wilderness Environ Med 2021 Mar 9;32(1):63-69. Epub 2020 Dec 9.

Ocala Regional Emergency Department, Ocala Regional Medical Center, Ocala, FL.

We present the case of a patient who developed myalgia as the primary symptom of envenomation by the eastern coral snake, Micrurus fulvius. The patient was evaluated and treated in the emergency department. Physical examination did not demonstrate any neuromuscular abnormalities. Read More

Toxicol Lett 2021 Feb 14;337:91-97. Epub 2020 Nov 14.

Toxin Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072 Australia. Electronic address:

Snakebite is a neglected tropical disease with a massive global burden of injury and death. The best current treatments, antivenoms, are plagued by a number of logistical issues that limit supply and access in remote or poor regions. We explore the anticoagulant properties of venoms from the genus Micrurus (coral snakes), which have been largely unstudied, as well as the effectiveness of antivenom and a small-molecule phospholipase inhibitor-varespladib-at counteracting these effects. Read More

Toxicon 2021 Jan 2;189:7-9. Epub 2020 Nov 2.

Faculty of Science, University of Peradeniya, Peradneiya, Sri Lanka.

Bite and envenomation by the slender coral snake (Calliophis melanurus sinhaleyus) is rare in Sri Lanka. This case report describes an authenticated slender coral snake envenomation that occurred in a 32-year-old male. The bite to the middle phalanx of the left index finger was allowed to persist for 10 minutes. Read More

JFMS Open Rep 2020 Jul-Dec;6(2):2055116920964001. Epub 2020 Oct 15.

Small Animal Neurology Services, Veterinary Medical Teaching Hospital, Texas A&M University, College Station, TX, USA.

Case Summary: A 2-year-old castrated male domestic longhair cat presented for acute, diffuse, flaccid paralysis. Thoracic and abdominal radiographs, biochemistry panel and complete blood count were unremarkable. Titers to , myasthenia gravis radioimmunoassay testing and creatinine kinase levels were within normal limits. Read More

J Am Anim Hosp Assoc 2020 Nov;56(6):320

From Texas A&M University, College Station, Texas (J.A.H., J.M.); and BluePearl Veterinary Partners, Clearwater, Florida (M.P.).

A 12 yr old dachshund, a 7 yr old English springer spaniel, and a 1.5 yr old French bulldog presented following envenomation by a coral snake. Each patient displayed evidence of varying degrees of lower motor neuron dysfunction, but all three developed transient megaesophagus. Read More

Am J Emerg Med 2021 07 29;45:309-316. Epub 2020 Aug 29.

Rocky Mountain Poison and Drug Center, 1391 Speer Blvd #600, Denver, CO 80204, United States of America; Department of Emergency Medicine, University of Colorado School of Medicine, 12401 East 17th Avenue, Aurora, CO 80045, United States of America.

Background: There are 5000-10,000 snake envenomations annually in the United States. Fortunately, few are fatal. In this study we review the epidemiology of fatal snakebites. Read More

Wilderness Environ Med 2020 Dec 5;31(4):466-469. Epub 2020 Oct 5.

Internal Medicine Unit, District General Hospital, Matale, Sri Lanka.

Blood-bellied coral snake (Calliophis haematoetron) is a recently discovered forest-dwelling species of elapid hitherto known from 3 specimens found from central Sri Lanka. Herein we describe the first authenticated case of blood-bellied coral snakebite. The victim, an 11-mo-old infant who received the bite while handling the snake at her home, had mild transient swelling at the bite site. Read More

South Med J 2020 Oct;113(10):514-519

From the College of Science, North Carolina State University, Raleigh, Marilyn Goss Haskell Innovative One Health Solutions, Raleigh, North Carolina, Albert Einstein College of Medicine, Bronx, New York, and Emory University, Atlanta, Georgia.

Objectives: Venomous and nonvenomous snakes are found throughout the United States. Two families of venomous snakes are indigenous to this country: the Viperidae, or pit vipers (rattlesnakes, cottonmouths, and copperheads), and the Elapidae (three species of coral snakes and a sea snake). Bites from captive nonindigenous venomous snakes such as cobras also may present at medical facilities, given the interest in exotic pet ownership in the United States. Read More

Toxicon 2020 Nov 23;187:232-244. Epub 2020 Sep 23.

Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, Acre, Brazil; Universidade Federal do Acre, Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde na Amazônia Ocidental, Rio Branco, Acre, Brazil; Programa de Pós-Graduação Bionorte, Universidade Federal do Acre, Campus Universitário - BR 364, Rio Branco, Acre, Brazil. Electronic address:

People who live in rural or forested areas are more likely to be affected by snakebites, due to their presence in the natural habitat of snakes and due to activities such as extractivism and agriculture. To conduct an ethnobiological study regarding the knowledge related to venomous snakes, snakebites and the attitudes of people who frequent areas of floodplain forests in the Alto Juruá (Brazilian Amazon), and correlate this information with data on snakebites in the region and the ecology of the ophiofauna, 100 residents, who are actively involved in extractivism, fishing, or hunting in the forests of the region were interviewed. Boards with photographs of venomous snakes from the region were used to ask questions about their experiences. Read More

Biologicals 2020 Nov 11;68:40-45. Epub 2020 Sep 11.

Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.

New world Coral snakes comprise 82 species of medical importance distributed from southeastern United States to Argentina. In Colombia, Micrurus mipartitus and M. dumerilii are responsible for most coral snakebite accidents. Read More

J Med Toxicol 2021 01 14;17(1):51-56. Epub 2020 Aug 14.

American College of Medical Toxicology, Phoenix, AZ, USA.

Introduction: Few of the 5000-8000 snakebites reported to poison control centers annually in the USA are attributed to coral snakes. This study describes Texas coral snake envenomations reported to the North American Snakebite Registry.

Methods: All Texas coral snake envenomation cases reported to the registry were identified for the period from January 1, 2015, through December 31, 2019. Read More

Int J Biol Macromol 2020 Dec 8;164:1908-1915. Epub 2020 Aug 8.

Departamento de Bioquímica e Imunologia, ICB, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, CEP: 31270-901 Belo Horizonte, Minas Gerais, Brazil. Electronic address:

Micrurus surinamensis (Cuvier, 1817), popularly known as aquatic coral snake, has a broad geographic distribution in the Rainforest of South America. The purpose of this study was to investigate the cytotoxic effect caused by M. surinamensis venom in H9c2 cardiomyoblast cells and to identify protein components involved in cardiotoxic processes. Read More

Toxicon 2020 Oct 22;185:193-202. Epub 2020 Jul 22.

Universidade Federal do Amazonas - UFAM, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Zoologia, Av. General Rodrigo Octavio, 1200, Coroado I, 69067-005, Manaus, Amazonas, Brazil.

Envenomation by coral snakes represents a little known burden in Brazilian Amazonia. So far, details on clinical and epidemiological aspects remain obscure in the region. We gathered data from medical charts and from the scientific collection of snakes from Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, finding 26 cases of envenomation by five species of Micrurus in Manaus region, between 1987 and 2018. Read More

Toxicon 2020 Jul 24;181:45-52. Epub 2020 Apr 24.

Federal University of Ceará (UFC), Department of Physiology and Pharmacology, Brazil. Electronic address:

The Micrurus snake venoms mainly cause systemic complications, essentially neurotoxicity. Previous studies, however, have described that they are involved in the occurrence of acute kidney injury (AKI) in animal models. AKI pathogenesis in snakebites is multifactorial and involves immunological reactions, hemodynamic disturbances, and direct nephrotoxicity. Read More

Toxicon 2020 Feb 27;175:7-18. Epub 2019 Nov 27.

Universidade Federal do Amazonas - UFAM, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Zoologia, Av. General Rodrigo Octavio, 1200, Coroado I, 69067-005, Manaus, Amazonas, Brazil.

Coral snakes constitute a relatively diverse and little known group of venomous snakes. So far, data for this kind of snakebite in the Amazon region are based only on case reports. This study takes advantage of novel data from the Brazilian Health Ministry database from 2010 to 2015 and presents a review of the cases reported in the literature regarding the Amazonian biome both from Brazil and nearby countries. Read More

J Vet Emerg Crit Care (San Antonio) 2019 Nov 18;29(6):662-667. Epub 2019 Oct 18.

College of Veterinary Medicine, Small Animal Clinical Sciences, North Carolina State University, Raleigh, North Carolina.

Objective: To describe the use of mechanical ventilation (MV) in the management of Eastern coral snake envenomation in 7 dogs and a cat.

Design: Retrospective study (2011-2016).

Setting: University teaching hospital. Read More

Mol Immunol 2019 12 7;116:45-55. Epub 2019 Oct 7.

Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela. Electronic address:

An acute inflammatory response, cellular infiltrates, anemia, hemorrhage and endogenous fibrinolysis activation were previously described in C57BL/6 mice injected with M. tener tener venom (Mtt). As the endothelium and innate immunity may participate in these disturbances and due to our poor understanding of the alterations produced by these venoms when the neurotoxic component is not predominant, we evaluated the effects in an in vitro model. Read More

Toxicon 2019 Aug 21;166:34-38. Epub 2019 May 21.

Laboratório de Herpetologia, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, Acre, Brazil. Electronic address:

Bites by Micrurus snakes in Brazilian Amazon represent about 0.4% of snakebite registered in that area. There is not information available about the M. Read More

Clin Toxicol (Phila) 2020 02 13;58(2):132-135. Epub 2019 May 13.

Campinas Poison Control Center, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.

To report two patients who developed systemic neurotoxicity after consecutive bites by the same coral snake. Two previously healthy men (32-year-old and 34-year-old) found a coral snake in a woodpile while collecting wood for a barbecue. During the barbecue, both men became drunk and "played" with the snake, believing that they were handling a false coral snake, and were bitten within a few minutes of each other. Read More