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Scorpion Sting


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The sting of the scorpion causes discomfort (moderate to severe), which reduces over a period of time. Discomfort is often described as a painful or burning sensation at the site of the sting. Severe reactions of the sting such as difficulty in swallowing, blurred vision, seizures, uncontrolled eye-movements, thick tongue and breathing problems, often considered a medical emergency, are observed. Deaths due to scorpion sting have also been reported [5] [6] [7].

Fever
  • We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour.[ncbi.nlm.nih.gov]
  • This was followed by a persistent high-grade fever which lasted for more than 2 weeks and was complicated by fatal Staphylococcus aureus infective endocarditis and septic pulmonary embolism.[ncbi.nlm.nih.gov]
  • Three patients presented with fever, and respiratory distress following scorpion sting. Their cardiac enzymes were abnormal. Electrocardiogram (ECG) of 3 patients showed features of myocardial strain with ST elevation.[ncbi.nlm.nih.gov]
  • Plot Synopsis Tigress has River Fever and it's up to Po and Monkey to bring back the cure .[kungfupanda.wikia.com]
  • Adverse events related to treatment included vomiting, fever, rash, nausea, itchiness, headache, runny nose, and muscle pain. Patients hypersensitive to horse proteins may have an early or delayed reaction to the antidote.[medpagetoday.com]
Localized Pain
  • The patient felt a severe sharp local pain that did not improve until he presented to the hospital 12 hours later. Block of the dorsal nerves of the penis with 1% lidocaine led to immediate relief of the pain.[ncbi.nlm.nih.gov]
  • Abstract Seventeen patients stung by Tityus serrulatus scorpion were classified as mild (pain at the site of the sting, n 6), moderate (local pain and one of the following manifestations: vomiting, psychomotor agitation, prostration, sweating, tachypnea[ncbi.nlm.nih.gov]
  • Local pain was the primary presenting complaint (95%), with a total systemic toxicity of 78.3% and 35.2% of these were children. Hypertension, sweating, salivation and tachycardia were the most common signs of systemic symptoms.[ncbi.nlm.nih.gov]
  • Grade IV: Local pain, CN abnormalities, somatic skeletal neuromuscular dysfunction, and airway involvement.[lasvegasemr.com]
  • The stings usually cause only localized pain with minimal swelling, some lymphangitis with regional lymphadenopathy, increased skin temperature, and tenderness around the wound.[merckmanuals.com]
Hypoxemia
  • Delay in recognition and the hypoxemia increase the morbidity and mortality.[ncbi.nlm.nih.gov]
Recurrent Infection
  • Both patients completed a 6-week postoperative course of antibiotic therapy and are without recurrent infection.[ncbi.nlm.nih.gov]
Dyspnea
  • On admission, the main clinical manifestations were: dyspnea, tachypnea, and tachycardia. Chest x-ray revealed APE predominantly on the right hemithorax.[ncbi.nlm.nih.gov]
  • Initial pain is followed within several hours by numbness, nausea, muscle spasm, dyspnea, and convulsion. Anascorp, an antivenin, was approved for use in the United States in 2011. The antivenin has been available in Mexico for many years.[medical-dictionary.thefreedictionary.com]
  • Browse recently published Learning/CME Learning/CME View all learning/CME CME A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis Case 10-2019: A 69-Year-Old Man with Progressive Dyspnea Mucinous Ovarian Carcinoma Challenge Yourself Interactive[nejm.org]
Vomiting
  • Important clinical features recorded were circulatory failure, breathlessness, profuse sweating, vomiting, local oedema and convulsion. Incidences of scorpion stings were much more frequent in the summer and rainy seasons than in the winter season.[ncbi.nlm.nih.gov]
  • These 20 shared characteristic clinical features such as vomiting, priapism and failure to maintain normal temperature and/or blood pressure. The management protocol emphasized fluid restriction and the i.v. administration of venom antitoxin.[ncbi.nlm.nih.gov]
  • We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour.[ncbi.nlm.nih.gov]
  • Abstract Seventeen patients stung by Tityus serrulatus scorpion were classified as mild (pain at the site of the sting, n 6), moderate (local pain and one of the following manifestations: vomiting, psychomotor agitation, prostration, sweating, tachypnea[ncbi.nlm.nih.gov]
  • Signs and symptoms resemble the bee sting such as hives, difficulty in breathing, nausea and vomiting. Scorpion sting appears as a barb that contains the protein toxin.[symptoma.com]
Nausea
  • We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour.[ncbi.nlm.nih.gov]
  • Experts said allergy to scorpions is actually extremely rare, and signs include hives, swelling, asthma symptoms, nausea, and vomiting. There is no update on the little girl's condition, as of Thursday evening.[fox10phoenix.com]
  • Signs and symptoms resemble the bee sting such as hives, difficulty in breathing, nausea and vomiting. Scorpion sting appears as a barb that contains the protein toxin.[symptoma.com]
  • Symptoms in these cases are similar to those of anaphylaxis caused by bee stings and can include trouble breathing, hives, nausea, and vomiting. Older adults and children are the most likely to die from an untreated venomous scorpion bite.[healthline.com]
Abdominal Pain
  • Chronic relapsing pancreatitis is a rare cause of abdominal pain in children and exceptionally rarely is related to a scorpion sting.[ncbi.nlm.nih.gov]
  • She got worse due to abdominal pain. Clinical findings were concordant with class III scorpion envenomation (major systemic manifestations), complicated by acute kidney injury and acute pancreatitis. Intensive supportive therapy was adopted.[ncbi.nlm.nih.gov]
  • Some symptoms of pancreatitis are abdominal pain, chills, fever, sweating, and nausea. Onset of symptoms is usually quite rapid and can last for between 24 to 48 hours.[boyslife.org]
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
Abdominal Cramps
  • Serious symptoms start within minutes of the sting and may include: Increased salivation (foaming at the mouth or drooling) Blurred vision Trouble focusing Slurred speech Muscle twitches Abdominal cramps Seizures Trouble breathing If you see any of these[thesurvivaldoctor.com]
Dysphagia
  • Seventeen patients with severe P. transvaalicus scorpionism showed sensory and motor nerve stimulation, with generalised hyperaesthesia, weakness, ptosis, dysphagia, muscle tremors and abnormal reflexes.[ncbi.nlm.nih.gov]
Drooling
  • : Intense pain Tingling and numbness in the area around the sting Swelling around the sting area If a bark scorpion bites, severe symptoms are visible, which are as follows: Unusual head, neck and eye movements Muscle twitching or thrashing Sweating Drooling[apollohospitals.com]
  • […] opiate analgesics may potentiate venom toxicity, and should be avoided; atropine is used to combat parasympathetic effects scorpion sting A toxic systemic response to scorpion venom Clinical SOB, opisthotonus, nasal and periorbital itching, dysphasia, drooling[medical-dictionary.thefreedictionary.com]
  • Serious symptoms include: Diarrhea and vomiting (throwing up) Fast heart beat Muscle jerks Restlessness Roving or wild eye movements Sweating Trouble swallowing and drooling Trouble breathing and wheezing Symptoms usually get better in 24-48 hours.[advocareparsippanypediatrics.com]
  • These severe symptoms include muscle twitching or thrashing; unusual head, eye, and neck movements; drooling; vomiting; severe sweating; high or low blood pressure; accelerated or irregular heartbeat; or restlessness or excitability.[varsitytermiteandpestcontrol.com]
  • […] concerns Self Care at Home Minor scorpion sting with symptoms only around the sting Waves of tingling and pain only up the arm or leg with the sting Preventing scorpion stings Call 911 Now Passed out or too weak to stand Trouble breathing or wheezing Drooling[eschildrens.com]
Foaming at the Mouth
  • Joshua Strommen, highlighted the similarities between the symptoms of a scorpion bite, including movement disorder, movement of upper and lower extremities, and some foaming at the mouth, and symptoms of methamphetamine exposure.[medicaldaily.com]
  • "These [symptoms] include some movement disorders, and movement of upper and lower extremities, and some foaming at the mouth," Shirazi told Live Science. [ 6 Strange Meth Facts ] When the girl arrived at the emergency department of a hospital in Tucson[livescience.com]
  • Serious symptoms start within minutes of the sting and may include: Increased salivation (foaming at the mouth or drooling) Blurred vision Trouble focusing Slurred speech Muscle twitches Abdominal cramps Seizures Trouble breathing If you see any of these[thesurvivaldoctor.com]
  • Foaming of the mouth, drooling, and vomiting. Muscles twitching and abnormal eye and neck movements. Difficulty breathing, talking, or swallowing. Severe swelling. Unintentional urination.[woundcaresociety.org]
Hypersalivation
  • Airway support is important and patients may require ventilation due to hypersalivation and autonomic dysfunction.[cdemcurriculum.com]
Tachycardia
  • After admission, the patient had four cardiac arrests (three episodes of pulseless ventricular tachycardia/ventricular fibrillation and one episode of asystole) over the next few hours.[ncbi.nlm.nih.gov]
  • On admission, the main clinical manifestations were: dyspnea, tachypnea, and tachycardia. Chest x-ray revealed APE predominantly on the right hemithorax.[ncbi.nlm.nih.gov]
  • It was seen that the non-survivors had significant tachycardia at admission, and a greater need for assisted ventilation compared to the survivors.[ncbi.nlm.nih.gov]
  • 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[ncbi.nlm.nih.gov]
  • Abstract Seventeen patients stung by Tityus serrulatus scorpion were classified as mild (pain at the site of the sting, n 6), moderate (local pain and one of the following manifestations: vomiting, psychomotor agitation, prostration, sweating, tachypnea, tachycardia[ncbi.nlm.nih.gov]
Hypertension
  • Though uncommon, scorpion stings can cause cerebrovascular accidents by various mechanisms such as venom induced autonomic storm leading to hypertension, hypotension, myocarditis, DIC or vasculitis by direct actions.[ncbi.nlm.nih.gov]
  • Stroke following scorpion sting is a rare complication and can occur by various mechanisms such as hypertension, hypotension, DIC, myocarditis and venom-induced vasculitis.[ncbi.nlm.nih.gov]
  • The most serious symptoms are hypertension, impaired left ventricular systolic function, hypotension and pulmonary oedema. Scorpion antivenin neutralizes circulatory and tissue venin. It has no action on effective effectors (Receptors).[ncbi.nlm.nih.gov]
  • Article Sidebar Published: May 3, 2013 Case Reports Keywords Scorpion, Sting, Woman, Furosemide, Hypertensive crisis.[italjmed.org]
  • 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[ncbi.nlm.nih.gov]
Hypotension
  • Hypotension (n 19), pulmonary oedema (n 15) and acute renal failure (n 8) were the other presenting features. Chest X-ray revealed cardiomegaly in 8 and pulmonary oedema in 13 patients.[ncbi.nlm.nih.gov]
  • Myocarditis, hypotension and hypoperfusion infarction is being considered as the possible explanation for this pathology.[ncbi.nlm.nih.gov]
  • Though uncommon, scorpion stings can cause cerebrovascular accidents by various mechanisms such as venom induced autonomic storm leading to hypertension, hypotension, myocarditis, DIC or vasculitis by direct actions.[ncbi.nlm.nih.gov]
  • Stroke following scorpion sting is a rare complication and can occur by various mechanisms such as hypertension, hypotension, DIC, myocarditis and venom-induced vasculitis.[ncbi.nlm.nih.gov]
  • The most serious symptoms are hypertension, impaired left ventricular systolic function, hypotension and pulmonary oedema. Scorpion antivenin neutralizes circulatory and tissue venin. It has no action on effective effectors (Receptors).[ncbi.nlm.nih.gov]
Heart Block
  • block developed postoperatively, requiring permanent pacemaker implantation.[ncbi.nlm.nih.gov]
  • The sinus tachycardia, injury to conducting system in the form of left anterior hemiblock, bundle branch block, complete heart block and marked tented T waves may be the other common findings.[slideshare.net]
Left Ventricular Dysfunction
  • M-mode, two-dimensional colour-flow Doppler echocardiogram showed left ventricular dysfunction.[ncbi.nlm.nih.gov]
Muscle Twitch
  • The bark scorpion, which is common in this area, has venom that causes symptoms like fast breaths, high blood pressure , a racing heart , weakness , and muscle twitches .[webmd.com]
  • The bark scorpion, which is common in this area, has venom that causes symptoms like fast breaths, high blood pressure, a racing heart, weakness, and muscle twitches.[webmd.com]
  • Common symptoms of a scorpion sting include: pain, tingling or burning sensation at the sting site malaise, sweating, nausea and vomiting salivating numbness muscle twitching abnormal neck, eye and head movements/twitching heart palpitations breathing[desertusa.com]
  • The venom of a bark scorpion can cause severe pain at a sting site, numbness, frothing at the mouth, difficulty breathing, respiratory paralysis, muscle twitching, and convulsions.[scorpionspecialists.com]
Blurred Vision
  • Serious symptoms start within minutes of the sting and may include: Increased salivation (foaming at the mouth or drooling) Blurred vision Trouble focusing Slurred speech Muscle twitches Abdominal cramps Seizures Trouble breathing If you see any of these[thesurvivaldoctor.com]
  • Severe reactions of the sting such as difficulty in swallowing, blurred vision, seizures, uncontrolled eye-movements, thick tongue and breathing problems, often considered a medical emergency, are observed.[symptoma.com]
  • Severe symptoms include shortness of breath, fluid in the lungs, breathing problems, excess saliva, blurred vision, slurred speech, trouble swallowing, abnormal eye movements, muscle twitching, thrashing of the arms and legs, trouble walking, and other[fda.gov]
  • Numbness, tingling, anxiety, nausea/vomiting, and blurred vision are common findings.[cdemcurriculum.com]
Diplopia
  • […] venom toxicity, and should be avoided; atropine is used to combat parasympathetic effects scorpion sting A toxic systemic response to scorpion venom Clinical SOB, opisthotonus, nasal and periorbital itching, dysphasia, drooling, gastric distension, diplopia[medical-dictionary.thefreedictionary.com]
Ptosis
  • Seventeen patients with severe P. transvaalicus scorpionism showed sensory and motor nerve stimulation, with generalised hyperaesthesia, weakness, ptosis, dysphagia, muscle tremors and abnormal reflexes.[ncbi.nlm.nih.gov]
Urinary Retention
  • Parasympathetic nervous system stimulation was seen in the absence of sympathetic stimulation, with profuse sialorrhoea, sweating and urinary retention.[ncbi.nlm.nih.gov]
Uremia
  • This condition is characterized by microangiopathic hemolytic anemia, thrombocytopenia, increased serum levels of lactate dehydrogenase and uremia.[ncbi.nlm.nih.gov]
Seizure
  • A 3-y-old child is reported who developed recurrent generalized tonic-clonic seizures 2 h after admission and hemiparesis on third day of admission following scorpion sting.[ncbi.nlm.nih.gov]
  • She was then taken to a hospital where she achieved suboptimal seizure control, with daily tonic-clonic seizures and left hemiplegia during the following week.[ncbi.nlm.nih.gov]
  • We report a case of 13-year-old male who was stung by a scorpion and developed a severe headache, visual disturbance, and seizures and had the diagnosis of PRES with a good outcome.[ncbi.nlm.nih.gov]
  • On the 5 th day, generalized seizures started again, as well as vomiting of gastric contents, cyanosis, and bradycardia.[scielo.br]
  • You have a seizure. You have trouble breathing. Call your doctor or nurse call line now or seek immediate medical care if: You have signs of infection, such as: Increased pain, swelling, warmth, or redness around the bite or sting.[myhealth.alberta.ca]
Agitation
  • Almost 84% of patients having a respiratory rate of or 30 breaths/minute associated with agitation and sweating were classified in the pulmonary edema group.[ncbi.nlm.nih.gov]
  • Abstract Seventeen patients stung by Tityus serrulatus scorpion were classified as mild (pain at the site of the sting, n 6), moderate (local pain and one of the following manifestations: vomiting, psychomotor agitation, prostration, sweating, tachypnea[ncbi.nlm.nih.gov]
  • Treatment of venomous Centruroides stings consists of bed rest, benzodiazepines for muscle spasms, and IV drugs as needed to control hypertension, agitation, and pain. Patients should be kept npo for 8 to 12 h after the bite.[msdmanuals.com]
  • Serious symptoms, most common among children, include Restlessness Muscle spasms Abnormal and random head, neck, and eye movements Anxiety and agitation Sialorrhea and diaphoresis In adults, tachycardia, hypertension, increased respirations, weakness,[merckmanuals.com]
Slurred Speech
  • You may have experienced a scorpion sting if you notice: • Sensitive Skin • Local Burning Pain • Slurred Speech • Breathing Problems • Body-Wide Numbness[scorpionspecialists.com]
  • Venomous scorpion stings occur most frequently in infants and children, and may cause shortness of breath, fluid buildup in the lungs, excess saliva, slurred speech, trouble swallowing, abnormal eye movements, muscle twitching, trouble walking, other[medpagetoday.com]
  • You should see a doctor if you experience more severe symptoms including: Numbness all over body Breathing trouble Difficulty swallowing Thick tongue and excessive salivating Slurred speech Restlessness Seizures Blurry vision Roving eye movements Muscle[my.clevelandclinic.org]
  • Serious symptoms start within minutes of the sting and may include: Increased salivation (foaming at the mouth or drooling) Blurred vision Trouble focusing Slurred speech Muscle twitches Abdominal cramps Seizures Trouble breathing If you see any of these[thesurvivaldoctor.com]
  • Other serious symptoms include: Trouble swallowing Trouble breathing Blurry eyesight Roving or jerky eye movements Slurred speech Muscle twitching Expert Reviewers: Anne-Michelle Ruha, MD, and Min Kang, MD, pediatric toxicologists When to Call for Scorpion[seattlechildrens.org]
Paresthesia
  • Scorpion stings are a cutaneous condition caused by the stinging of scorpions, usually resulting in pain, paresthesia, and variable swelling.[en.wikipedia.org]
  • Edema Nausea and vomiting Hyperthermia Respiratory failure Erythema Urticaria Sweating Dysgeusia Grades of Scorpion Envenomation Grade I: Local pain and/or paresthesias Grade II: Local and remote pain and/or paresthesias Grade III: Local pain with paresthesias[lasvegasemr.com]
  • The patient soon developed local pain and paresthesias followed by diaphoresis and somnolence. Approximately 24 hours after the sting, she began to convulse.[ncbi.nlm.nih.gov]
  • The neurotoxins block ion channels, particularly sodium and potassium, causing pain and paresthesias. Secondary systemic effects are caused by massive release of acetylcholine and catecholamines.[visualdx.com]
  • Of the 1200 species of scorpions worldwide, only a few cause more than a painful sting. [2] Some of the other significant medical effects that may follow scorpion stings include paresthesia, cardiovascular collapse, respiratory failure, hypertensive crisis[njcponline.com]
Nystagmus
  • In addition he has had difficulty walking, abnormal movements where he clenches his fists, draws his feet up, numbness of his tongue, and rotary nystagmus. Parents have noticed some scorpions outside of their property.[lasvegasemr.com]
  • The patient was admitted with dry oral mucosae, drowsiness, nystagmus, rales, no abdominal changes, and augmented osteotendon reflexes.[scielo.br]
  • […] avoided; atropine is used to combat parasympathetic effects scorpion sting A toxic systemic response to scorpion venom Clinical SOB, opisthotonus, nasal and periorbital itching, dysphasia, drooling, gastric distension, diplopia, transient blindness, nystagmus[medical-dictionary.thefreedictionary.com]

Workup

Scorpion venom may or may not require extensive laboratory work, depending on the species of scorpion. Here, the laboratory studies that can be done are mentioned below:

  • CBC: Complete blood count or CBC helps to ascertain leukocytosis and hemolysis in patient with scorpion sting
  • Coagulation parameters: At higher concentration, the venom acts as an anticoagulant.  
  • Measurement of glucose levels can help to evaluate hyperglycemia, which is often induced by the scorpion sting. 
  • Urinalysis: Measuring the levels of creatine kinase and performing urinalysis can help assess motor rhabdomyolysis in patient with scorpion sting. In some cases, renal failure occur secondary to hemolysis.
  • Pancreatitis is common from the venom of Tityus trinitatis stings.
  • Liver parameters: Patient with the scorpion stings may have elevated levels of aspartate aminotransferase and alanine aminotransferase. 
  • There is an increase in the levels of Interleukin (IL)–1 level in all the scorpion stings. In severe envenominations, there is an elevated levels of interferon-gamma, IL-6 and granulocyte-macrophage colony-stimulating factor.
  • Arterial Blood Gas (ABG) indicates any respiratory distress caused due to the scorpion venom [8] [9].

Treatment

In most cases, the treatment is supportive. It is advised to wash the region with soap and water. Patient may be advised to remove the jewelry as the body can swell in response to the sting. Applying cool compress has proved beneficial in most cases. Analgesics can help relieve pain that ensues after the sting. Choice of analgesic is acetaminophen as aspirin and ibuprofen can aggravate complications. Antibiotics are beneficial only in case of secondary infection [10].

Prognosis

In patients who are older than 6 years, death occurs rarely. A poor outcome is likely if the symptoms worsen 2-4 hours after the scorpion sting.

Complications

Severe complications of the scorpion sting are the allergic reactions which may be life-threatening. Signs and symptoms resemble the bee sting such as hives, difficulty in breathing, nausea and vomiting [5] [6].

Etiology

Scorpion sting appears as a barb that contains the protein toxin. This toxin is not pure, but is a mixture of several proteins such as neurotoxin and protein inhibitors along with other similar substances.

The type of toxin depends on the species. This difference is believed to evolve to target a specific prey and vary from species to species. Only around 2% of the scorpions are dangerous to humans. In fact, maurotoxin and chlorotoxin are the two toxins used for the research of the diseases including cancer [2] [3].

Epidemiology

Scorpion bites are common in the tropical and temperate regions of the globe. Most of the sting occurs during evenings of summer, outside the home. Though accurate data is not available, it is estimated that around 1.2 million people are stung by scorpion per year.

Deaths due to scorpion sting generally occurs secondary to the cardiovascular and respiratory failure within 24 hours of the sting. Children and elderly are more like to be killed by the scorpion sting. Though there is no racial predilection, according to the data, females are more susceptible to the scorpion venom because of lower body weight [4].

Sex distribution
Age distribution

Pathophysiology

After the sting of the scorpion, the venom enters the human body through the blood (intravenous route). Generally, the peak concentration of the venom is reached after 30 minutes of the sting. It is believed that the more rapidly the venom reaches the bloodstream, the higher is its concentration in the blood with rapid onset of symptoms. The scorpion-venom is a water-soluble and heterogeneous mixture (the scorpion venom is composed of different concentrations of neurotoxin, cardiotoxin, hemolytic toxin, hyaluronidases, histamine, serotonin, etc.). The clinical effects of the venom are neuroanatomic, local tissue effect and neuromuscular with the primary targets being voltage-dependent ion channels. Some of the effects are as follows:

  • Neuronal activity: The toxins cause the alteration of the ion channels. 
  • Cardiopulmonary effects: The autonomic excitation caused by the scorpion venom can cause cardiovascular effects. 
  • Neuromuscular overstimulation: There can be cranial as well as somatic nerve hyperactivity by the scorpion venom. 
  • Among the different types of scorpion venom, the neurotoxin is the most potent. They are responsible for the impairment of the cell in the nerves, and muscles (including the cardiac muscle) as they alter the ion-channel permeability [3].

Prevention

Scorpion sting can be prevented by taking some precaution such as wearing clothes after shaking them, or dislodging the shoes with scorpions. While going to the park, it is often advised to cover the entire body to avoid contact with this Arachnida. Use of pesticides in the regions with significant populations of scorpion can also work. It is also required to brush off the scorpion from the skin instead of slapping it as it is more likely to sting. People who are working in scorpion prone areas must use Scorpion glow or UV light to locate this organism.

Summary

Scorpions belong to the kingdom Animalia and class Arachnida. Belonging to the same class as spiders, mites and ticks, scorpions have a stinger at the last tail segment. The scorpion transmits the toxin through this stinger.

Though most of them are harmless, around 40 scorpions can deliver venom that can cause lethal damage to the humans, sometimes even causing death. Contact with scorpions is generally accidental. Scorpions are found in arid regions, temperate regions and deserts. Since the scorpions hunt at night, the chances of interaction with it, increases at night [1].

Patient Information

Definition

Scorpion sting is the transfer of the venom or toxin (neurotoxin and protein inhibitors) from the scorpion to the host. 

Cause

When one is exposed to the environment with scorpion, there is an increased chance of interaction between this Arachnida and humans. The complications that arise due to this interaction can be moderate (nausea, inflammation and vomiting) to life-threatening conditions. These arthropods are nocturnal that often resists stinging, unless threatened.

Symptoms

Most of the sting of the scorpions brings about only minor signs such as intense pain, numbness, slight swelling, and warmth in the region. Muscle twitching, sweating, vomiting, drooling and high blood pressure, restlessness and irregular heart rate are some of the severe symptoms of the condition.

Diagnosis

The doctor can ask about the personal history of the patient. This assists in making accurate diagnosis of the condition. If there are severe symptoms, blood and imaging tests may be performed to assess the impact of the venom.

Treatment

Once bitten by the scorpion, applying ice-pack to the region is considered as the first step. Removing jewelry from the body can prevent complications arising from swelling. Pain-killers can help alleviate pain. Anti-venom for some of the species of deadly scorpion is available.

References

Article

  1. Steen CJ, Schwartz RA. Arthropod bites and stings. In: Wolff K, Goldsmith LA, Katz SI, et al., eds. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, NY: McGraw-Hill; 2008:chap 210.
  2. Bawaskar HS, Bawaskar PH. Scorpion sting: update. J Assoc Physicians India. Jan 2012;60:46-55.
  3. Suchard J. Scorpion Envenomation. In: Auerbach PS, ed. Wilderness Medicine. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2011:chap 53.
  4. Chippaux JP, Goyffon M. Epidemiology of scorpionism: a global apprasial. Acta Trop. 2010/08;107:71-9.
  5. Freire-Maia L, Pinto GI, Franco I. Mechanism of the cardiovascular effects produced by purified scorpion toxin in the rat. J Pharmacol Exp Ther. Jan 1974;188(1):207-13
  6. Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, et al. Pulmonary edema following scorpion envenomation: mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol. Jan 10 2013;162(2):86-91
  7. Bawaskar HS. Diagnostic cardiac premonitory signs and symptoms of red scorpion sting. Lancet. Mar 6 1982;1(8271):552-4
  8. Guerra CM, Carvalho LF, Colosimo EA, Freire HB. Analysis of variables related to fatal outcomes of scorpion envenomation in children and adolescents in the state of Minas Gerais, Brazil, from 2001 to 2005. J Pediatr (Rio J). Nov-Dec 2008;84(6):509-15.
  9. Amaral CF, Lopes JA, Magalhaes RA, de Rezende NA. Electrocardiographic, enzymatic and echocardiographic evidence of myocardial damage after Tityus serrulatus scorpion poisoning. Am J Cardiol. Mar 15 1991;67(7):655-7
  10. Chippaux JP. Emerging options for the management of scorpion stings. Drug Des Devel Ther. 2012;6:165-73

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Last updated: 2018-06-22 10:48