Which clinical feature is associated with coral snake envenomation?

• A. Local tissue necrosis
• B. Blockade of neurotransmission leading to respiratory paralysis
• C. Hemorrhagic coagulopathy
• D. Severe edema with blistering

Answer: (B)

Coral snake venom is primarily neurotoxic, causing paralysis by blocking transmission of nerve impulses to the muscles. This leads to weakness that can rapidly progress to respiratory failure as the respiratory muscles are affected. Because the venom mainly targets the nervous system, there is often little or no local tissue damage initially, which contrasts with bites from many other snakes that produce local necrosis, bleeding/coagulopathy, or severe edema with blistering. So the hallmark feature is blockade of neurotransmission resulting in respiratory paralysis, with patients commonly developing symptoms such as facial weakness, slurred speech, or difficulty breathing as the paralysis progresses.