title: Five-year experience with Chinese cobra (Naja atra)--related injuries in two acute hospitals in Hong Kong.
abstract: OBJECTIVE
  To review the clinical features and management of patients with injuries related to the Chinese cobra (Naja atra).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Two acute hospitals in Hong Kong.
  
  
  METHODS
  The nature of injuries, envenoming features, complications, response to antivenom therapy, and outcome.
  
  
  RESULTS
  Eighteen patients were recruited during the 5-year study period. Fifteen of them were snake-bitten, the remaining three suffered ocular injuries. Of the 15 patients with cobra bites, 14 (93%) presented with local swelling. No patient developed severe neurotoxic symptoms. Two patients had laboratory features of haemolysis. Fourteen patients received antivenom therapy and five of them subsequently underwent surgical interventions for extensive local tissue damage and necrosis. There was no fatality.
  
  
  CONCLUSIONS
  Bites from Chinese cobra result in serious local complications with extensive tissue necrosis and minimal neurotoxic symptoms. There is an apparent trend of favourable outcomes following the early administration of antivenom to patients without early signs of irreversible tissue damage. Further research is needed to evaluate the effectiveness of early antivenom use in Chinese cobra bites in order to minimise extent of tissue damage.
authors.affiliation: Department of Accident and Emergency Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong. oifungwong@yahoo.com.hk
authors.forename: O F
authors.initials: OF
authors.lastname: Wong
authors.forename: T S K
authors.initials: TS
authors.lastname: Lam
authors.forename: H T
authors.initials: HT
authors.lastname: Fung
authors.forename: C H
authors.initials: CH
authors.lastname: Choy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000209:etiology; D002648:Child; D004546:Elapid Venoms / Q000633:toxicity; D017815:Elapidae; D005260:Female; D006461:Hemolysis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012909:Snake Bites / Q000150:complications / Q000628:therapy*; D013997:Time Factors
chemical_list: D000997:Antivenins; D004546:Elapid Venoms