{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:45:24Z","timestamp":1777934724732,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The Texas coral snake,\n                      <jats:italic>Micrurus tener<\/jats:italic>\n                      , is one of three elapid species native to the continental United States. The purpose of the study was to describe the clinical features of their envenomation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We reviewed all human coral snake bites reported to the Texas Poison Center Network between January 2000 and December 2023. We excluded informational calls and cases in which the snake responsible for the bite was not confirmed as\n                      <jats:italic>M. tener<\/jats:italic>\n                      . Finally, we excluded bite victims who did not seek medical attention and those for whom no clinical information was available. The data collected included patient demographics, the county in which the patient was treated, clinical features, and treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 501 human bites. In 472 (94.2%) cases, symptoms were limited to pain and paresthesias. Systemic toxicity, for example, weakness, dysphagia, and ptosis, was observed in 18 (3.6%) patients. Eleven (2.2%) patients had no clinical findings. Antivenom was administered in 126 (25.1%) cases. Antivenom use decreased over time; in the 5-year period from 2000\u20132007, antivenom was administered to 74 (55.6%) patients. Conversely, only 8 (4.1%) of patients from 2016\u20132023 received antivenom. Systemic findings were observed in 13 (6.5%) cases in Northeast and Central Texas compared to 5 (1.6%) in Southeast and South Texas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Micrurus tener<\/jats:italic>\n                      envenomations were characterized primarily by pain and paresthesias. Additional systemic findings may be observed, particularly in Northeast and Central Texas. Antivenom was administered to a minority of Texas coral snake envenomation victims.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10806032251327124","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T12:42:02Z","timestamp":1742388122000},"page":"328-334","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Regional Differences in Systemic Toxicity Following Texas Coral Snake (\n                    <i>Micrurus tener)<\/i>\n                    Envenomations"],"prefix":"10.1177","volume":"36","author":[{"given":"Spencer","family":"Greene","sequence":"first","affiliation":[{"name":"University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA"},{"name":"HCA Houston Healthcare \u2013 Kingwood, Kingwood, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Anderson","sequence":"additional","affiliation":[{"name":"HCA Houston Healthcare \u2013 Kingwood, Kingwood, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misty","family":"Wilcken","sequence":"additional","affiliation":[{"name":"Southeast Texas Poison Center, Galveston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietrich","family":"Jehle","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn","family":"Varney","sequence":"additional","affiliation":[{"name":"South Texas Poison Center, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2019.1677022"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2020.1834219"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2021.1989785"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2022.2132768"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2023.2268981"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0041-0101(67)90116-X"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03400120065026"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2013.828841"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-020-00806-3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000253596.39121.19"},{"key":"e_1_3_3_12_2","unstructured":"North American Coral Snake Antivenin (Equine) package insert. Available at: https:\/\/www.pfizer.com\/products\/product-detail\/north_american_coral_snake_antivenin. Accessed on June 29 2024."},{"key":"e_1_3_3_13_2","unstructured":"Coralmyn. Available at https:\/\/bioclon.com.mx\/. Accessed on June 30 2024."},{"key":"e_1_3_3_14_2","unstructured":"Coral-ICP. Products for Human Use. Available at https:\/\/icp.ucr.ac.cr\/en\/services-and-products\/products-human-use. Accessed on June 29 2024."},{"key":"e_1_3_3_15_2","unstructured":"CroFab\u00ae package insert. https:\/\/www.fda.gov\/media\/74683\/download. Accessed on June 28 2024."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2013.10.005"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra013477"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050218"},{"key":"e_1_3_3_19_2","unstructured":"THIS is the Snake to Worry About. Available at: https:\/\/www.youtube.com\/watch?v=98tkbIuZT3k. 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