As in other diseases, diagnosis is crucial in effective management of snakebite.
There are three principle diagnostic questions: is this a snakebite, or some
other condition, and if it is a snakebite, is there significant envenoming present
and to what extent, and lastly, what type of snake was responsible?
The diagnosis of snakebite may be obvious, as in the patient who presents after
being bitten by their pet snake, but such cases are the exception. If a snakebite
is known to have occurred, it is likely the identity of the snake is unknown,
but there are numerous cases where there is no history of a bite, just a set
of symptoms to be explained, where snakebite may not even be thought of initially.
Therefore, diagnosis of snakebite is sometimes simple (the snake keeper bitten
by their pet), but often difficult and occasionally obscure. This is especially
true for children, who may present with sudden unexplained collapse and convulsions
following snakebite, with neither history of a snakebite, nor visible bite marks.
Think of snakebite in the differential diagnosis of patients presenting with
unexplained collapse, convulsions, progressive flaccid paralysis, myolysis,
coagulopathy or renal damage.
The elements of diagnosis are essentially the same for snakebite as in other
areas of medicine:
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