Case reports

Papua New Guinea
Blasco and Hornabrook 1972: 1 case; very doubtful identification; discussion of several cases with a similar course.

Warrell et al. 1996: 11 cases. Identification: immunological, morphological (1/11). Systemic envenoming 6/11, no clinical evidence of envenoming 5/11.

Signs & symptoms

Autopharmacological effects

Vomiting 1/6 an dizziness 2/6 within 1h of the bite (Warrell et al. 1996).

Vomiting (Blasco and Hornabrook 1972).

Local effects

Local swelling at the site of the bite 2/6, local pain 1/6, local lymphadenopathy 2/6 (Warrell et al. 1996).

Haemostatic effects

Incoagulable blood 2/6 with spontaneous bleeding in 1/2 (Warrell et al. 1996).

Neurological effects

4/6 (ptosis 4/6, bulbar 3/6, limbs 3/6) (Warrell et al. 1996).

Paralysis of the extremities and respiratory musculature resulting in death (Blasco and Hornabrook 1972).

Muscular effects

Generalized muscle pain / tenderness 3/6, trismus 1/6, dark urine (Warrell et al. 1996).

Cardiac effects

See Laboratory and physical investigations below.

Renal effects

Dark urine. (Warrell et al. 1996).

Morbidity

-

Case fatality rate

2/11 (19 and 38h after the bite; respiratory paralysis) (Warrell et al. 1996).

Treatment (specific)

Antivenoms
Polyvalent (Australia-New Guinea), CSL, Parkville, Australia may be beneficial (Warrell et al. 1996).

Anecdotally, CSL death adder antivenom has proved ineffective (Warrell et al. 1996).