Intense local pain, swelling, ecchymoses, and oozing of the haemolysed blood from the site of snake bite, is most likely to occur with bite of which species of snake?

Ans. b (Viper). (Ref. Harrison's internal medicine 16th ed. 615, 2593)SNAKEBITEApproximately 2500 different species of snakes are known. Approximately 20% of the total numbers of the snake species are poisonous.Types of Poisonous Snakes1. Cobra and Krait - these secrete neurotoxic venom and cause Paralysis2. Viper - these secrete Haemotoxic venom and cause Haemolysis and Haemorrhage.3. Sea Snakes - secrete myotoxic venom and cause Muscular painCharacteristic FeaturesNonpoisonous SnakesPoisonous SnakesHeadRoundedTriangle except CobraFangsNot presentPresentPupilsRoundedElliptical pupilAnal PlateDouble row of platesSingle row of platesBite MarkRow of small teeth.Fang Mark1. Cobra or Krait (Neurotoxic):# Mild Local symptoms -- burning, redness, swelling, superficial necrosis.# Marked neurotoxic effects.# Earliest symptom - Ptosis - inability to keep Eyes open.# Giddiness, Lethargy, Muscle weakness.# Spreading Paralysis - causing difficulty in speaking and breathing, Salivation, Vomiting. Frothing around mouth.2. Viper (Vasculotoxic):# Haemotoxic venom is very painful# Severe Local symptoms -- Intense Pain, Inflammation, Oozing of haemolytic blood.# Marked Vasculotoxic effects.# Bleeding from mucous membrane of the Mouth, Anus, Nose and hemorrhages under the skin.# Because of local damage to circulatory cells, hemotoxic venom spreads more slowly and has a slower action than the neurotoxins.# Vascular Collapse - Cold Skin, Rapid feeble Pulse, Dilated Pupils insensitive to light, Gradual loss of consciousness.3. Sea Snakes (Myotoxic)# No Local symptoms.# Severe Pain while moving Neck, Trunk and Limbs. A few hours later urine turns Brown to Black due to the presence of muscle protein Myoglobin.