Bites and Stings

  • Christeine Ariaranee Gnanathasan
  • Subramanian Senthilkumaran


Antivenom is the mainstay of therapy for poisonous snakebite and there is no role for test dose.


Acute Kidney Injury Scorpion Venom Hymenoptera Venom Scorpion Sting Yellow Jacket 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Warrell DA. WHO/SEARO Guidelines for the clinical management of snake bites in the Southeast asian Region. Trop Med Pub Heath. 1999;30:1.Google Scholar
  2. 2.
    Warrell DA. Snake bite. Lancet. 2010;375:77–88.CrossRefPubMedGoogle Scholar
  3. 3.
    Mohapatra B, Warrell DA, Suraveera W, Bhatia B, Dhungra N, Jokkar RM, Rodriguez PS, Mishra K, Whitaker R, Jah P. For the million death study collaborators. Snake bite mortality in India. A National representative mortality survey. Plos Negl Trop Dis. 2011;5(4):e1018.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kasturiratne A, et al. The global burden of snake bite: a literature analysis and modeling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5:e 218.CrossRefGoogle Scholar
  5. 5.
    Senthilkumaran S, Meenakshisundaram R, Thirumalaikolundusubramanian P, Menezes RG. Cardiac toxicity following cobra envenomation. Clin Toxicol (Phila). 2012;50(9):862.CrossRefGoogle Scholar
  6. 6.
    Senthilkumaran S, Khamis A, Manikam R, Thirumalaikolundusubramanian P. Snakebite and severe hypertension: looking for the holy grail. Indian J Crit Care Med. 2014;18:186.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Senthilkumaran S, Balamurugan N, Menezes RG, Thirumalaikolundusubramanian P. Snake bite and brain death-cause for caution? Am J Emerg Med. 2013;31:625–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Ariaratnam CA, Sheriff MHR, Arambepola C, Theakston RDG, Warrell DA. Syndromic approach for treatment of snake bite in Sri Lanka: based on results of a prospective national hospital-based survey of patients envenomed by identified snakes. Am J Trop Med Hyg. 2009;81(4):725–31.CrossRefPubMedGoogle Scholar
  9. 9.
    Ariaratnam CA, Rezvi Sheriff MH, David R, Theakston G, Warrell DA. Distinctive epidemiologic and clinical features of common krait (Bungarus caeruleus) bites in Sri Lanka. Am J Trop Med Hyg. 2008;79(3):458–62.PubMedGoogle Scholar
  10. 10.
    Senthilkumaran S, David SS, Jena NN, Thirumalaikolundusubramanian P. Limitations and consumer aspects of point-of-care in snake envenomation. Emerg Med Aust. 2014;26(2):208.CrossRefGoogle Scholar
  11. 11.
    Ariaratnam CA, Thuraisingam V, Kularatne SAM, Sheriff MHR, Theakston RDG, De Silva A, Warrell DA. Frequent and potentially fatal envenoming by hump-nosed pit vipers (Hypnale hypnale and H. nepa) in Sri Lanka: lack of effective antivenom. Trans R Soc Trop Med Hyg. 2008;102:1120–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Isbister GK, Bawaskar HS. Scorpion envenomation. N Engl J Med. 2014;371(5):457–63.CrossRefPubMedGoogle Scholar
  13. 13.
    Mahadevan S, Rameshkumar R. Systemic manifestations in children with scorpion sting envenomation: how to manage? Indian J Pediatr. 2015;82(6):497–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Chippaux JP. Emerging options for the management of scorpion stings. Drug Des Dev Ther. 2012;6:165–73.CrossRefGoogle Scholar
  15. 15.
    Bawaskar HS, Bawaskar PH. Prazosin in management of cardiovascular manifestations of scorpion sting. Lancet. 1986;1(8479):510–1.CrossRefPubMedGoogle Scholar
  16. 16.
    Bawaskar HS, Bawaskar PH. Prazosin therapy and scorpion envenomation. J Assoc Physicians India. 2000;48(12):1175–80.PubMedGoogle Scholar
  17. 17.
    Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus sting: randomised open label clinical trial. BMJ. 2011;341:c7136.CrossRefGoogle Scholar
  18. 18.
    Goddard J. Physician’s guide to arthropods of medical importance. 4th ed. Boca Raton: CRC Press; 2003. p. 4.Google Scholar
  19. 19.
    Balamurgan N, Senthilkumaran S, Thirumalaikolundusubramanian P. Mass envenomation by honey bee-speed thrills. J Emerg Trauma Shock. 2010;3:420–1.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Senthilkumaran S, Ananth C, Benita F, Thirumalaikolundusubramanian P. Acute kidney injury in wasp sting-do early bicarbonate and mannitol make a difference? Indian J Crit Care Med. 2014;18:701–2.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  • Christeine Ariaranee Gnanathasan
    • 1
  • Subramanian Senthilkumaran
    • 2
  1. 1.Faculty of MedicineUniversity of ColomboColomboSri Lanka
  2. 2.Department of Emergency and Critical CareSri Gokulam HospitalsSalemIndia

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