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At least 19 recordsLinked to original sources

PubMed2003

Increased plasma levels of IL-1beta, IL-6, IL-8, IL-10 and TNF-alpha in patients moderately or severely envenomed by Tityus serrulatus scorpion sting.

Scorpion envenomation is a common medical problem in many countries and an important cause of morbidity and mortality, especially among children. The plasma levels of pro-inflammatory (IL-1beta, IL-6, IL-8 and TNF-alpha) and anti-inflammatory (IL-10) cytokines were measured in individuals stung by Tityus serrulatus (Ts) scorpions. According to clinical manifestations patients were classified, as defined by the Brazilian Ministry of Health, as having mild (n=15, mean age=42.2 years), moderate (n=8, mean age=26 years) or severe (n=4, mean age=14 years) envenomation. Blood samples were taken immediately (T1) and 6h (T2) after admission to the hospital. Eighteen age-matched healthy volunteers were used as control. TNF-alpha, IL-1beta, IL-6 and IL-8 levels were significantly increased in moderate and severe cases and the levels of these cytokines were positively correlated with the severity of envenomation, as evaluated by clinical profile and plasma venom concentration. IL-10 levels were increased in severe and moderate cases and reduced in mild cases. The results reported in the present study suggest that the physiopathological manifestation of Ts envenomation may be mediated, at least in part, by cytokines, and that the early treatment after scorpion sting with drugs that inhibit cytokine production, such as glucocorticoids, may have a potential beneficial effect, ameliorating the severity of the clinical manifestations observed, particularly in severe and moderate cases.

Adolescent↗

PubMed2006

Bilateral cerebellar infarction: a rare complication of scorpion sting.

INTRODUCTION: Complications following scorpion sting are common in India and can be fatal. Stroke following scorpion sting is a rare complication and can occur by various mechanisms such as hypertension, hypotension, DIC, myocarditis and venom-induced vasculitis. We present a rare case of extensive cerebellar infarction following scorpion sting, which has rarely been reported in medical literature. OBJECTIVES: To study the clinical profile of two patients presenting with an acute onset of cerebellar symptoms following a scorpion sting. To evaluate the possible causes of the stroke and to study the relation of their symptoms to the scorpion sting. METHODS: Two young women presented with a history of acute onset of dysarthria, ataxia and incoordination following scorpion sting. They did not have any known risk factors for stroke. They had cerebellar type of dysarthria and cerebellar signs on both sides along with incoordination. A CT-scan of the brain showed bilateral extensive cerebellar infarctions. They were investigated for other causes of stroke without any positive results. With treatment the patients made a gradual but complete recovery. CONCLUSION: Since there was no evidence of hypertension, hypotension, myocarditis or disseminated intravascular coagulation, we can conclude that the patients had suffered a thrombotic stroke caused by the vasculotoxic action of the scorpion venom.

Acute Disease↗

PubMed2004

Scorpion stings in Australia: five definite stings and a review.

Despite scorpions being locally abundant in many parts of Australia, scorpion sting is a poorly defined clinical condition in Australia. Many health-care workers are unaware of the effects of their stings and scorpions are often feared based on their international reputation. Five scorpion stings that occurred in different parts of Australia where the scorpion was caught at the time of the sting and identified by a professional arachnologist are reported in the present paper. The spectrum of clinical effects of scorpion stings in Australia and the potential for significant effects are discussed. These cases and recent prospective case series demonstrate that in Australia scorpion stings cause only minor effects. The main effect is localized pain lasting for several hours, associated less commonly with systemic effects, local numbness and paraesthesia. Most stings are from smaller scorpions from the family Buthidae and often occur indoors at night. The stings from Australian buthid scorpions cause more severe effects than from the larger species in the families Urodacidae (genus Urodacus) and Liochelidae (genus Liocheles).

Adult↗

PubMed2003

Australian scorpion stings: a prospective study of definite stings.

There is little information on scorpion stings in Australia. The aim of this study is to describe the circumstances and clinical effects of stings by Australian scorpions. Cases of scorpion stings were collected prospectively from calls and presentations to Australian poison information centres and emergency departments from February 2000 to April 2002. Only definite scorpion stings where the scorpion was immediately collected and expertly identified were included. There were 95 patients, 33 males and 62 females, with a mean age of 32 (SD 19.5; range 1-71) and 23 children (age<15 years). Three families of scorpions caused all stings: Buthidae (79), Bothruiridae (11, all Cercophonius spp.) and Urodacidae (five, all Urodacus spp.). The majority of stings (76%) were by one genus of scorpion Lychas spp. Seventy one percent of stings occurred between 6pm and 8am and 82 (86%) occurred indoors. Sixty percent of stings occurred on distal limbs. The median duration of effects was 6 h (interquartile range (IQR): 1-24 h). Immediate localised pain occurred in all cases and was severe in 76 cases (80%). Other local effects included red mark/redness (66%), tenderness (35%), numbness (12%) and paraesthesia (11%). Minor systemic effects (nausea, headache and malaise) occurred in 11% of cases. There were no deaths or major systemic envenoming. Less severe effects were observed for the larger Urodacus species, compared to Lychas spp. Scorpion stings in Australia do not appear to cause severe or life-threatening effects, even in children. This differs from other parts of the world, where severe envenoming is reported. The major clinical effect is severe pain, consistent with other scorpion stings. Most stings occurred indoors and at night.

Adolescent↗

PubMed2003

Evaluation of scorpion stings: the poison center perspective.

Scorpion venom causes excessive adrenergic discharge and cardiotoxicity. Publications on scorpion stings using mainly admission data, has led to the belief that most scorpion stings are severe and mandate an observation period of at least 12 h regardless of symptomatology. We to assessed the characteristics of scorpion sting victims with emphasis on severity and time to presentation by retrospective poison center chart review of 225 calls over 12-mo. Thirteen percent of patients were asymptomatic and 72% and 15% were mild or moderately to severely ill, respectively. The most frequent manifestations were pain (97.3%), cardiovascular signs (23.1%) and ECG changes (13.7%). Ninety-four percent of the patients presented within 6 h; 86% within 3 h. Ninety-two percent of moderate to severe patients, including those with moderate to severe cardiotoxicity, presented within 3 h; 100% within 6 h. Clinical severity of the stings was greater in females than in males. No association was found between degree of severity and time to presentation and age. Most scorpion stings in Israel (at least those occurring in the north and central regions) are mild. The majority of envenomated patients present for medical assistance within 3 h including all patients with moderate to severe cardiotoxicity. Because of severity of potential complications, that scorpion sting victims should be observed in the emergency department for 6 h from the time of sting and should be admitted if symptoms other than local pain develop. Reduction of unnecessary in-hospital observation time is expected to save public health money.

Adolescent↗

PubMed1988

[Scorpions and scorpion stings in Jordan].

The scorpion fauna of Jordan consists of fourteen species belonging to three families (Buthidae, Scorpionidae and Diplocentridae), of which three species are poisonous: Leiurus quinquestriatus, Adroctonus crassicauda and Buthus occitanus. A key to all species is included. Five hundred and forty-seven cases of scorpion stings were reported during 1982-1985, including two fatalities. Clinical data for sixteen cases treated at the Jordan University Hospital are summarized. In Jordan human and cultural customs are related to scorpion stings. Sting accidents according to age groups and seasons are given.

Adolescent↗

PubMed1991

Scorpion sting: a management problem.

Admissions for scorpion sting in 1 year and deaths resulting from scorpion sting over 3 years were analysed. Features that indicated the severity of the clinical condition were identified. Pulmonary oedema and shock were the usual causes of death. Poor management of fluid therapy was responsible for the frequently unsatisfactory resolution of envenoming, especially when purified human plasma was used. The role of the scorpion antivenom used is questioned and controversy regarding the most appropriate sedative to use in the management of scorpion sting is still not resolved. An in-depth study of these management issues is urgently required.

Animals↗

PubMed2003

[National strategy in the battle against scorpion stings and envenomations. Application and evaluation].

Scorpion stings represent the first cause of poisoning with an incidence of 30 to 50% of all declared cases in the Centre Anti Poison of Morocco (CAPM). Aware of this increasing problem, the CAPM paid special attention to this pathology. Thanks to its retrospective and prospective studies, the scorpion species mapping has been determined as well as the demographic features of stung patients, the nature and the chronology of clinical events in scorpion envenimation, and the epidemiological, clinical and therapeutical factors of severity. On this basis, the CAPM worked out a national strategy to struggle against scorpion stings whose aim was to decrease the morbidity and mortality caused by stings of scorpion as well as to rationalise economic expenses. The components of this strategy were based on the training of the medical and paramedical staff, on information, education, communication involving different sectors, on identification of needs and on follow-up and assessment. A nationwide campaign was implemented to change the population and health-care staff's behaviour regarding this pathology. Its evaluation permitted to improve the compilation of cases with census of 14104 cases, to reduce lethality rate and to rationalise expenses while banishing some medicines and avoiding useless hospitalization.

Animals↗

PubMed1989

Epidemiological characteristics of scorpion sting in León, Guanajuato, México.

Poisoning with scorpion venom in the city of León, Guanajuato state, México, is a significant public health problem. The hospital of the Mexican Red Cross gave medical attention to 38,068 cases of envenomation by scorpion sting during 1981-1986; 77% of all accidents occurred among persons under 30 years of age. The 100% survival rate can be attributed to prompt serotherapy. Most stings were due to scorpions from the species Centruroides infamatus infamatus. Scorpion stings increase dramatically in the spring and are lowest during winter. The distribution of scorpions throughout the city is uniform and accidents occur at any time of day or night with no preference in regard to the sex of the affected persons. The epidemiological aspects of scorpion poisoning are emphasized.

Animals↗

PubMed2004

[Establishment and analysis of a log to record scorpion stings in Morocco].

Within the framework of a strategy against scorpion stings, an information system was established to track the indicators of morbidity and mortality caused by scorpion stings. The study of these indicators was carried out based upon a national record of scorpion stings. During the year 2001, 15,571 cases of scorpion stings were reported, that translates into an incidence rate of 1.2%. The patients were poisoned in 11.6% of the cases. Most of the patients (79.3%) were only put under clinical surveillance and did not receive any symptomatic treatment. The death rate was 6.3% and death only occurred in children of less than 15 years old (2.1% of the cases). This study demonstrated an improvement in morbidity and mortality indicators in comparison to the data collected before this campaign, all of which verifies the positive impact of the strategy which was put into place. However, it is necessary to continue monitoring until Morocco can overcome this problem.

Adolescent↗

PubMed1999

Efficacy of serotherapy in scorpion sting: a matched-pair study.

BACKGROUND/OBJECTIVE: Although evidence of scorpion antivenin effectiveness in the clinical setting is lacking, scorpion antivenin is generally considered the only specific treatment for scorpion sting irrespective of its clinical severity. We conducted a matched-pair study to assess the efficacy of systematic administration of scorpion antivenin. METHODS: Among 600 stung patients who participated in a study on the efficacy of high-dose hydrocortisone after scorpion sting, 135 (cases) had been treated with 10 to 20 mL intravenous scorpion antivenin (neutralizing 10 LD50 venom/mL). Controls were matched on disease severity on arrival to the emergency department. The severity of envenomation was graded I or II according to the absence (grade I) or the presence (grade II) of systemic manifestations of scorpion envenomation. Assessment of scorpion antivenin efficacy was based on the rate of changing severity grade in both groups (clinical improvement or worsening during an observation period of at least 4 hours). RESULTS: Both groups were similar with respect to clinical severity (36 patients were graded II in each group), age, sex, time-lapse between scorpion sting and ED arrival, and the administration of adjunctive therapy such as hydrocortisone. By the 4-hour evaluation, 50% and 64% of patients initially graded II exhibited a substantial clinical improvement in cases and controls, respectively, suggesting similar effects in cases and controls. There was no difference in preventive effects: 13% and 10% of cases and controls developed systemic manifestations of scorpion envenomation during the 4-hour observation period; 23% of cases and 17% controls were hospitalized by this time. There was no difference in the duration of hospitalization. Three cases developed anaphylactic shock as a consequence of scorpion antivenin administration, while 1 scorpion antivenin-untreated patient died from refractory shock. CONCLUSION: Systematic administration of scorpion antivenin irrespective of clinical severity did not alter the clinical course of scorpion sting. A prospective study is needed concerning the response of the more severe scorpion envenomations.

Adolescent↗

PubMed1997

Scorpion sting in Zimbabwe.

OBJECTIVE: To describe the epidemiological and clinical features of scorpion stings in a district with potentially lethal scorpions. DESIGN: Case series of consecutive scorpion sting victims. SETTING: Manama Hospital and all seven rural health centres in Gwanda South District, Zimbabwe (population 62500). PARTICIPANTS: All known cases of scorpion sting reporting to health centres in the district; all severe cases in which the scorpions had been identified, and who were admitted and examined by the author between September 1991 and September 1993. MAIN OUTCOME MEASURES: Description of clinical features of severe Parabathus transvaalicus scorpionism. RESULTS: Two hundred and forty-four cases, of which 184 were P. transvaalicus Purcell, 1899. Seventeen patients with severe P. transvaalicus scorpionism showed sensory and motor nerve stimulation, with generalised hyperaesthesia, weakness, ptosis, dysphagia, muscle tremors and abnormal reflexes. There was cardiac involvement, and respiration was compromised secondary to muscular weakness. Parasympathetic nervous system stimulation was seen in the absence of sympathetic stimulation, with profuse sialorrhoea, sweating and urinary retention. CONCLUSIONS: The clinical features of P. transvaalicus scorpionism are described for the first time. These resemble those of P. granulatus scorpionism which, however, has significant sympathetic nervous system stimulation, the distinguishing features being visual disturbances, anxiety, restlessness and raised blood pressure. Scorpion antivenom should be given for both. General recommendations on management of scorpion stings are given.

Adult↗

PubMedDate not supplied

[Scorpion stings: a public health problem in Morelos (Mexico)].

Scorpion stings represent a major public health problem in Mexico. Their annual incidence is estimated at 150,000 cases; 800-1,000 people die from them each year, 72.5% of whom are children younger than 5 years old. The states most affected are Aguascalientes, Colima, Durango, Guanajuato, Guerrero, Jalisco, Michoacán, Morelos, Oaxaca, Puebla, Sinaloa, and Zacatecas. Morelos is an endemic zone, and scorpion stings are relatively frequent, but the indigenous population underestimates the risks. In this locality, scorpion stings lead to high morbidity, with an average of 10,219 cases each year, and a prevalence varying from 584.86 per 100,000 inhabitants in 1994 to 2043.3 per 100,000 inhabitants in 2003. Because of this upsurge, systematic medical supervision and serum therapy are necessary if scorpion poisoning is suspected in a child. The indigenous community as well as tourists visiting Mexico must be informed about the substantial risk of scorpion poisoning.

Adolescent↗

PubMed1999

Penis wound by scorpion sting.

CONTEXT: The majority of scorpion stings are oligosymptomatic, occurring mainly on the hands and feet. Fatality is rare. CASE REPORT: A 33-year old man suffered a severe sting on his penis from a scorpion of the species Tytius trivittatus. Alcohol and salt were used without success in an effort to relieve pain. Medical assistance was sought 4 hours after the event, at which time diffuse erythema, edema and punctiform injury on the glans penis were observed, with no systemic manifestation. Intravenous meperidine was administered with immediate relief of the pain. The local signs disappeared within 48 hours, with the patient remaining asymptomatic.

Adult↗

PubMed1991

Cardiovascular manifestations of severe scorpion sting in India (review of 34 children).

Scorpion sting in children is a hazardous and potentially fatal condition. Of 34 children admitted to hospital in Mahad, Maharashtra State, India following scorpion sting, 14 had hypertension (130/90-170/130 mmHg), five had myocardial failure, acute pulmonary oedema developed in nine, two had tachycardia (110-200/min) and four died. Analysis of data suggests that cardiovascular morbidity and mortality depend upon the time lapse between sting and administration of vasodilators. Current management of human scorpionism consists of early admission to hospital and immediate reduction of raised blood pressure with sublingual nifedipine while peripheral action of venom is antagonized by the post-synaptic alpha blocker prazosin; in addition, digoxin, frusemide, aminophylline and oxygen are administered. The patient is kept under close surveillance in an intensive care unit. Massive life-threatening pulmonary oedema is treated with a sodium nitroprusside drip. We suggest that aggressive medical management directed at the organ system specifically affected by scorpion venom can be effective.

Adolescent↗

PubMedDate not supplied

[Scorpion stings outbreaks in recently constructed urban dwellings inhabitants].

Scorpion stings are unfrequent in Chile. Most of cases occur in rural areas during the warm season. Clinical manifestations have a low to moderate intensity and consist in local pain and inflammation, sometimes associated with headache and hyperthermia. Two autbreaks of scorpion stings--affecting six and five adult residents (18-42 years old) of recently built urban dwelling complexes--have been recorded in Chile in summertime of 1957 and 1998. The first took place in the town of Maipú and the second in Villa Alborada sites respectively 10 and 150 km South of the city of Santiago. The Maipú dwelling complex was constituted by 112 one story houses in which lived 504 people. In Villa Alborada live 1,050 persons distributed in 158 apartments, 86 of which are in the main floor and in 26 of these last the occupants have observed scorpions inside. All the 11 cases occurred into the dwelling: four when sleeping at night, three performing different activities (trying to find a tool, searching a kee, housekeeping), two when putting their shoes, and two walking with bare feet in dormitory. In all the cases the causative scorpion was observed, captured or destroyed. Identification of six specimens from Maipú corresponded to Brachistoternus ehrenbergi and of two from Villa Alborada to Bothriurus borrelianus. All the patients presented mild to moderate symptomatology. Treatment consisted basically in oral antihistamanic and/or antinflammatory tablets. Recovery was observed within one to seven days with a mean of three days. Prophylactic measures consisted in health education and physical destruction of scorpions in Maipú and insecticide spraying on floors of basement apartments and surrounding areas in Villa Alborada. Though the majority of accidents by scorpion stings happens in rural areas, also may occur in urban areas--rural in the near past--where dwellings have been constructed in fields which in not to much preterit times constituted the habitat of the referred arthropod, phenomenom that have occurred in summertime in the two dwelling complexes described in the present communication.

Adolescent↗

PubMed2006

Myocarditis and multiple cerebral and cerebellar infarction following scorpion sting.

An unusual case of scorpion sting followed by multiple cerebral and cerebellar watershed infarctions is being reported. Myocarditis, hypotension and hypoperfusion infarction is being considered as the possible explanation for this pathology. Hypoperfusion leading to parieto-occipital infarction has been reported earlier, however cerebellar infarction in this context is extremely rare.

Adult↗

PubMed2005

Predicting scorpion sting incidence in an endemic region using climatological variables.

Scorpionism is a public health problem in several regions of the world. The highest mortality, with over 1000 deaths per year, has been reported in Mexico. We analysed the significance of climatological variables to predict the incidence of scorpion stings in humans in the state of Colima (Mexico) for the years 2000-2001. The pluvial precipitation (mm), the evaporation (mm), and the mean, maximum, and minimum temperatures (degrees C) were obtained from local meteorological offices. There are approximately 3 stings/year per 1000 people in municipalities of Colima and Villa de Alvarez and about 18-30 stings/year per 1000 people in the rest of the municipalities. There is very little rain and there are few stings in the winter when the minimum temperature is below about 16 degrees C. The number of scorpion stings is independent of the actual rainfall when this is above 30 mm/month. Using multiple linear regression, we used a backward model selection procedure to estimate that the minimum temperature is correlated with scorpion sting incidence with a statistically significance of 95%. We briefly discuss the application of predictive models of scorpion sting incidence in the appropriate allocation of antivenom serum in hospital clinics.

Animals↗