The course after envenomation is rapidly progressive. In severe cases death may occur within an hour of the sting.
Clinical findings:
(1) intense, sharp pain upon being stung, followed shortly by numbness around the site of the sting
(2) feeling faint and clammy
(3) paralysis of voluntary muscles
(3a) inability to speak or slurred speech
(3b) difficult swallowing
(3c) generalized muscular weakness
(3d) blurring of vision with diplopia
(3e) paralysis of the diaphragm and respiratory muscles, resulting in cyanosis and leading to respiratory failure
(4) numbness and/or paresthesias in the stung extremity, which may become generalized
(5) ataxia
(6) diminished reflexes
(7) cerebral edema, decreased consciousness and coma
