Clinical Profile and Management Outcomes of Krait and Cobra Envenomation: A 3-year Observational Study from Rural Maharashtra, India

Background: Snake bite envenomation remains a critical public health concern in rural India, with the Indian Cobra (Naja naja) and Common Krait (Bungarus caeruleus) responsible for a significant proportion of morbidity and mortality. Despite shared neurotoxic venom properties, these species display distinct clinical manifestations and management outcomes, necessitating species-specific approaches to treatment. Materials and Methods: A retrospective observational study was conducted from 2021 to 2023 at a rural healthcare facility in Junnar Taluka, Maharashtra. A total of 62 visually confirmed cases of snakebite envenomation (28 krait, 34 cobra) were included. Socio-demographic characteristics, clinical features, management parameters, and outcomes were systematically recorded and analyzed. Results: Young adults (21–30 years) were the most affected group. Krait bites showed a female predominance (57.1%) and typically occurred in early morning hours, while cobra bites were more common among males (64.7%) and occurred during daytime. Krait envenomation presented with minimal local signs but significant systemic complications, including high rates of ventilatory support (53.6%) and cardiorespiratory arrest (53.6%). In contrast, cobra bites exhibited marked local effects, such as swelling (91.2%) and necrosis (32.4%), with lower ventilatory requirements (29.4%). Neurological features also varied: krait bites frequently resulted in paralysis and coma, while cobra bites predominantly caused ptosis and dysarthria. Local surgical interventions were required in 20.6% of cobra cases. Access to care varied, with travel distances up to 100 km and delays in admission more pronounced in cobra cases. Conclusion: Distinct species-specific clinical patterns underscore the need for differential diagnosis and tailored management protocols for krait and cobra envenomation. Enhanced awareness, timely intervention, and region-specific treatment strategies are vital for improving outcomes in rural snakebite victims.