Abstract
Objective: To present a case of a serious manifestation of scorpion sting, which was not reported before in Qatar, review the literature, and compare with previously reported similar cases.Case presentation and intervention: A young male patient was admitted to CCU with a clinical picture of acute toxic myocarditis and cardiogenic shock with abnormal ECG and elevated cardiac markers after a scorpion sting to his right big toe. Thorough investigations, including echocardiography, cardiac MRI and right heart catheterization, supported the diagnosis. Coronary angiography was normal. Patient was managed conservatively with supportive measures, mechanical ventilation, IV fluids, inotropic agents, steroids, antibiotics and Prazocin. Over 9 days of hospital course, patient gradually improved, was successfully extubated, and was discharged in a stable condition.Conclusion: Toxic myocarditis (with myocardial damage), pulmonary edema and cardiogenic shock are reported manifestations of scorpion venom intoxication.
Highlights
Creatures that are capable of producing a poison in a gland and delivering that toxin by stinging or biting are called venomous animals
A 24-year-old Nepalese male patient who worked as a shepherd in a suburban farm in Doha, Qatar, and with no significant past medical history, presented to the emergency room with a sudden onset of nausea, vomitting, dizziness and profuse sweating around 30 minutes after a scorpion sting to the right big toe
Cardiovascular involvement include hemodynamic disturbances with hypertensive phase and tachycardia dominating the majority of cases, this can be associated with hypertensive encephalopathy
Summary
Creatures that are capable of producing a poison in a gland and delivering that toxin by stinging or biting are called venomous animals. A 24-year-old Nepalese male patient who worked as a shepherd in a suburban farm in Doha, Qatar, and with no significant past medical history, presented to the emergency room with a sudden onset of nausea, vomitting, dizziness and profuse sweating around 30 minutes after a scorpion sting to the right big toe. A physical examination revealed a young male patient who was conscious, oriented but anxious He looked sick, sweaty, pale and dyspnic. By this time patient had received the scorpion anti-venom (1 vial intravenous), IV hydrocortisone 200 mg, and 2000 ml of normal saline over 4 hrs. After one week of CCU course, patient was off-sedation, fully conscious, afebrile wih stable hemodynamics. He was maintaining good oxygen saturation on 40% FiO2, with clear lung fields. Patient was discharged home in a stable condition, on proton pump inhibitor (Rabiprazole 20mg once/day) and a plan for outpatient follow up
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