Case reports

Montgomery 1959 (case 2: unambiguous morphological identification; case 1: taxonomic identification based on the circumstances of the bite and the clinical picture).

Ellis 1979: 2 cases; taxonomic identification based on the circumstances of the bite and the clinical picture.

Paget and Cock 1979: 1 case; unambiguous morphological identification.

Signs & symptoms

Autopharmacological effects

Nausea, vomiting (Ellis 1979, Montgomery 1959).

Local effects

Local pain and local swelling. Possible necrosis (Ellis 1979, Montgomery 1959).

Neurological effects

Loss of senses of smell and taste. Progressive paralysis of the external and internal eye muscles ending in complete ophthalmoplegia. Onset of symptoms within an hour after the bite, at the latest approximately 24 hours. Resolution of symptoms from the 4th day after the bite, and from the 6th day substantial recovery of functions dependent on cranial nerves III, IV and VI (Ellis 1979, Montgomery 1959).

No neurological symptoms despite marked local pain and swelling that extended as far as the trunk (Paget and Cock 1979).

Morbidity

Local swelling with necrosis. Neurological symptoms disappeared without residual effects (Ellis 1979).

Case fatality rate

None reported to date.

First aid

Compression bandage or comparable measures not advised due to possible exacerbation of local effects (Ellis 1979).

Treatment (symptomatic)

Bed rest, prophylactic administration of antibiotics (Ellis 1979).

Treatment (specific)

Antivenoms
No antivenom available (Ellis 1979).