We report two cases of spotted black snake (Pseudechis guttatus) envenoming. One patient experienced localised burning pain around the bite and developed nausea, vomiting, diarrhoea, upper abdominal cramping and diaphoresis. He was treated with intravenous fluids and antiemetics, but no antivenom, and was discharged 23 hours after the bite. The second patient developed a severe headache, blurred vision and mild nausea, associated with severe pain and swelling of the bitten limb that took 4 days to resolve. No antivenom was given and the patient had no sequelae. Neither patient developed significant coagulopathy, myolysis or neuromuscular paralysis. Bites by this species appear to cause effects similar to those of the more common red-bellied black snake (P. porphyriacus).
A 47-year-old male farmer in the Upper Hunter region of New South Wales was bitten by a spotted black snake and developed non-specific systemic effects with localised pain and swelling. The snake came from under a bale of hay and bit him on the dorsal aspect of the right foot. He applied a 7.5 cm elastic bandage up to the knee within 5 minutes, and arrived at the local hospital asymptomatic. The patient had no significant past medical history and took no regular medications. The dead snake was identified as Pseudechis guttatus by G K I, using a key for identification.1
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Geoff Isbister is supported by a National Health and Medical Research Council (NHMRC) Clinical Career Development Award ID300785.
Julian White is employed by the Women’s and Children’s Hospital, Adelaide, which is paid by CSL Ltd to provide a consultant clinical toxinology service for users of CSL antivenom and venom detection products.