Nephrotoxicity in krait bite: a rare case series of three fatalities in consecutive bites by a single snake

Abstract

Background: Death due to poisonous snakebite is a formidable health hazard. It is a matter of concern especially in agrarian countries. Clinically snakebite envenomation are neurotoxic and vasculotoxic. Krait (Bungarus faciatus) Venom is essentially neurotoxic.Nephrotoxicity in krait bite is an important issue that has been less studied and reported. Case presentation: In the present series, we report three cases of deaths in consecutive bites by a single banded krait.Significant renal involvement was found at autopsy. The kidneys showed interstitial haemorrhage and inflammatory cell infiltration. The renal changes were similar in all the three cases bitten by the same snake. Conclusions: From the findings of autopsy and histology of the present case series we can conclude that nephrotoxicity is an important effect of krait bite. Though less reported and researched kidney changes in krait bite is a significant issue in treatment as well as autopsy diagnosis. We can also infer that the immunogenicity of the snake venoms can be different from our expectation.