Case Report: Cryptic Neurotoxic Envenomation Mimicking a Localized Facial Reaction—The Critical Role of Syndromic Triage in Unwitnessed Nocturnal Snakebites
Himanshu Gupta Assistant Professor, Department of Emergency Medicine, JNU-IMSRC, Jaipur, Rajasthan,, India
Kush Patel Third Year Resident, Department of Emergency Medicine, JNU-IMSRC, Jaipur, Rajasthan, India
Preety Alka Chingakham Second Year Resident, Department of Emergency Medicine, JNU-IMSRC, Jaipur, Rajasthan,, India
Address for correspondence: Himanshu Gupta, Assistant Professor, Department of Emergency Medicine, JNU-IMSRC, Jaipur, Rajasthan,, India E-mail: dr.himanshu0882@gmail.com
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Himanshu Gupta, Kush Patel, Preety Alka Chingakham. Case Report: Cryptic Neurotoxic Envenomation
Mimicking a Localized Facial Reaction—The Critical Role of Syndromic Triage in Unwitnessed Nocturnal
Snakebites. Ind J Emerg Med. 2026; 12(3): 129-134.
Timeline
Received : June 15, 2026
Accepted : July 20, 2026
Published : September 30, 2026
Abstract
Background: Snakebite Envenomation is a time-limiting, acute medical emergency and a significant public health hazard in rural and suburban India. Neurotoxic Envenomation, predominantly caused by the Common Krait (Bungarus caeruleus),
presents profound diagnostic dilemmas. Because Kraits are nocturnal and possess fine fangs, their bites are frequently painless, lack significant local signs, and can escape the patient’s awareness. When a patient presents with atypical soft tissue swelling or an alternative medical history, significant diagnostic delays and rapid clinical deterioration can occur.
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Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
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Cite this article
Himanshu Gupta, Kush Patel, Preety Alka Chingakham. Case Report: Cryptic Neurotoxic Envenomation
Mimicking a Localized Facial Reaction—The Critical Role of Syndromic Triage in Unwitnessed Nocturnal
Snakebites. Ind J Emerg Med. 2026; 12(3): 129-134.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.