A 55-year-old female bitten by a snake five hours ago reports generalized weakness. The snake had bands of color and is not poisonous. She reports blurred vision; pupils are four millimeters and reactive. What type of snake should you suspect?

• A. King snake
• B. Corn snake
• C. Milk snake
• D. Coral snake

Answer: (D)

A neurotoxic envenomation is the key idea. Coral snake venom affects the nervous system, leading to weakness and cranial nerve–related symptoms such as blurred vision from muscle involvement of the eyes. This typically progresses over hours after a bite, which fits the five-hour timeline described. Even though the snake was described as color-banded and “not poisonous,” color patterns are not reliable indicators of venomous versus nonvenomous snakes, and the patient’s signs point to a neurotoxin effect.

Nonvenomous snakes like king, corn, and milk snakes do not cause the same systemic neuro symptoms; their bites, if any, don’t produce this pattern of vision changes and generalized weakness. So the presentation best fits coral snake envenomation, which is a venomous neurotoxic snake.

In management terms, treat as a potential venomous bite: monitor airway and vital signs, immobilize the patient, transport promptly, and prepare for antivenom if indicated.