Onset of symptoms | Local symptoms
- Onset usually soon after the bite but in some cases symptoms may be mild and progress for up to 2-3 days.
- They may last several weeks.
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Systemic symptoms
- After an average of 0.5-4 hours (once the venom has been absorbed); in some cases with delay
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Local symptoms | Pain, dark/purple discolouration and swelling spreading proximally |
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Subcutaneous haematoma and blistering possible |
Necrosis or compartment syndrome rarely develop but patients should be monitored for these. |
Intestinal symptoms | Vomiting, diarrhoea, abdominal pain and paralytic ileus |
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Central nervous symptoms | Irritability, headache, convulsions, impaired consciousness, paraesthesias, visual disturbances |
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Cardiovascular symptoms | Vasodilation, hypotension, hypovolaemia, conduction disorders and arrhythmias, myocardial ischaemia |
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In the most extreme cases, hypovolaemic and/or anaphylactoid shock |
Renal symptoms | Oliguria, proteinuria, haematuria (renal damage) |
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Blood | Haemolytic anaemia, leucocytosis, thrombocytopenia, rarely generalized disseminated intravascular coagulopathy (DIC) |
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Other symptoms | Rarely rhabdomyolysis, pancreatitis, pulmonary oedema |
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Late symptoms | (Limb) muscle rigidity, restricted movement, dysaesthesias, swelling tendency and dark discolouration may last several weeks or months. Permanent discolouration, chronic pain and neurological symptoms are also possible. |
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