Abstract
White scorpion (Hottentotta tamulus), also known in India as the ‘red scorpion’, was not sighted in Sri Lanka until 1990, leading to the belief that the species migrated to Jaffna peninsula with the movement of Indian Peace Keeping Force (IPKF) in 1987 with their luggage. There has been a gradual increase in cases reported with Hottentotta tamulus stings since the end of civil war in 2009 with confirmed 22 hospital admissions (out of 78 stings by scorpions) in 2013 [1]. White scorpion toxin contains polypeptides which cause sympathetic and parasympathetic stimulation leading to signs and symptoms ranging from swelling and severe local pain along the affected dermatome to an ‘autonomic storm’ causing tachyor bradycardia, hypoor hypertension, priapism, excessive salivation, pulmonary oedema and rarely myocarditis.
Highlights
White scorpion (Hottentotta tamulus), known in India as the ‘red scorpion’, was not sighted in Sri Lanka until 1990, leading to the belief that the species migrated to Jaffna peninsula with the movement of Indian Peace Keeping Force (IPKF) in 1987 with their luggage
After 24 hours of envenomation, pulmonary oedema improved, requiring only 2 l of oxygen to maintain a saturation of 98%, and a normal blood pressure and pulse rate
A 34-year old farmer came to the emergency unit of the Teaching Hospital, Jaffna after a white scorpion (Hottentotta tamulus) sting on the dorsum of the foot an hour earlier
Summary
White scorpion (Hottentotta tamulus), known in India as the ‘red scorpion’, was not sighted in Sri Lanka until 1990, leading to the belief that the species migrated to Jaffna peninsula with the movement of Indian Peace Keeping Force (IPKF) in 1987 with their luggage. White scorpion toxin contains polypeptides which cause sympathetic and parasympathetic stimulation leading to signs and symptoms ranging from swelling and severe local pain along the affected dermatome to an ‘autonomic storm’ causing tachy- or bradycardia, hypo- or hypertension, priapism, excessive salivation, pulmonary oedema and rarely myocarditis. The patient was managed in the intensive care unit with 8 l of oxygen, intravenous frusemide and ipratropium bromide nebulisation. After 24 hours of envenomation, pulmonary oedema improved, requiring only 2 l of oxygen to maintain a saturation of 98%, and a normal blood pressure and pulse rate. A coronary angiogram and an echocardiogram performed after a month of the incident were normal
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