By Sp.herp - CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=22342896
Clinical Case Reports on Black Krait (Bungarus niger/lividus) Neurotoxic Snakebites in Assam, Northeast India
The greater black krait (Bungarus niger) and the lesser black krait (Bungarus lividus), venomous snakes of the Elapidae family, pose a significant health risk in Assam, Northeast India. However, their clinical effects remain underreported. A retrospective analysis was performed on 10 cases of envenomation attributed to B. niger/B. lividus. The patients were admitted to a rural health center and two adjacent hospitals in Assam. The victims exhibited severe neurotoxic symptoms, including ptosis, quadriplegia, respiratory muscle weakness, dysphonia, dysphagia, myalgia, and a gradual generalized neuromuscular weakening culminating in respiratory paralysis. The subjects were administered standard commercial polyvalent antivenom (PAV) targeting the “big four” snakes of India along with calcium gluconate (20 mg/kg). Standard antivenom was ineffective in reversing the established neuromuscular blockade; however, early administration of PAV before venom-induced damage to the presynaptic granules was linked to accelerated recovery in certain patients. Supportive care, including elective endotracheal intubation and assisted ventilation, was critical for recovery.
Giri S, Kakati H, Taye SJ, et al. Clinical Case Reports on Black Krait (Bungarus niger/lividus) Neurotoxic Snakebites in Assam, Northeast India. The American Journal of Tropical Medicine and Hygiene. e tpmd250472 Published online December 18, 2025. doi:10.4269/ajtmh.25-0472
