The envenomation syndrome caused by the Australian Red-bellied Black SnakePseudechis porphyriacus

The Australian elapids inject venom which is characteristic of each species ; and which cause characteristic and specific envenomation syndromes in hum an victims of snakebite. Because many of the medically significant Australi an elapids look similar, when glimpsed in the field by snakebite victims, d efining human envenomation syndromes with secure species identification has been a slow process. Correlations between securely identified species and the human envenomation syndromes which they produce are still evolving. The genus Pseudechis is the most widespread in Australia of the dangerous Aust ralian elapid genera; and P. porphyriacus, the Red-bellied Black Snake, was the first terrestrial Australian elapid to be described and illustrated an d the first to be the subject of experimental study. We present here five p reviously unreported cases of human envenomation in which the species diagn osis is secure. From these and with the perspective of a selected literatur e review, we describe the full envenomation syndrome of this species. Until the development of the Commonwealth Serum Laboratories' Venom Detection Ki t in 1979 and the occasional case report of victims of securely identified species, envenomation syndromes for most Australian snake species have rema ined indeterminate, because of the lack of professional expertise in the id entification of the species involved. Symptoms of the P. porphyriacus enven omation syndrome include those of bite-site pain, nausea and vomiting, gene ralised pruritis. chest pain, prostration and abnormalities of taste and sm ell. Signs include local necrosis and scarring of tissue at the bite-site, gross inflammation of surrounding tissues and, at least in one case, epilep sy. Although envenomation by the Red-bellied Black Snake is not lethal in a dults, the correct therapy is Tiger Snake antivenom, administered with judg ement, taking into account knowledge of the specific envenomation syndrome of this species and the clinical status of the victim. (C) 2000 Elsevier Sc ience Ltd. All rights reserved.