Fatal neurotoxic envenomation from the bite of a Lesser Black Krait (Bungarus lividus) in Nepal.

The Lesser Black Krait (Bungarus lividus) is a small, secretive, nocturnal elapid snake inhabiting Nepal, Bangladesh and India. We report a case of B. lividus bite in Nepal resulting in burning sensation at the bite site and over the whole body, abdominal pain, vomiting, slurred speech, ptosis, and progressive generalized neuromuscular paralysis leading to respiratory distress and death. Only one other case of fatal envenomation by this species has been reported previously in India. This demonstrates that B. lividus contributes to snakebite mortality in South Asia. As few snakebite victims in this region kill and bring the snake and because the clinical syndromes appear similar, envenomation by B. lividus may be misdiagnosed as envenomation by Common Kraits (Bungarus caeruleus). External morphology characters that distinguish B. lividus from B. caeruleus and other krait species are illustrated.