Abstract
Scorpion sting is a public health issue in several countries, particularly in America, the Middle East, India and Africa. The estimated annual global incidence of scorpion envenomings is about 1.5 million, resulting in 2600 deaths. Scorpions are Arthropoda characterized by a tail ending in a terminal bulbous (telson) containing paired venom glands and the stinger. There are 19 known families of scorpions and more than 2200 species, of which about 50 from the families of Buthidae, Hemiscorpiidae and Scorpionidae are harmful to humans. Scorpion venom is a complex structure composed of neurotoxic proteins, salts, acidic proteins and organic compounds, thereby having neurologic, cardiovascular, hematologic and renal side effects, in addition to local effects such as redness, pain, burning and swelling. When the sting is fatal, the mechanism of death is often related to cardiotoxicity with terminal pulmonary edema. However, the cholinergic excess or the neuromuscular excitation can provoke respiratory failure. Sometimes, death is due to an anaphylactic reaction to the envenoming. The purpose of this literature review is to evaluate the autopsy findings in scorpion sting-related deaths in order to better understand the pathophysiological mechanisms underlying them, thus helping pathologists in defining the correct diagnosis.
Highlights
Scorpion sting is a public health issue in several countries, in America, the MiddleEast, India and Africa [1,2,3,4,5,6,7,8,9,10]
Scorpionism epidemiology in the world is poorly known [11], even if it has been estimated that the annual global incidence is about 1.5 million envenomings, resulting in 2600 deaths [12]
An electronic search of SCOPUS, PubMed and Web of Sciences databases was performed to recognize the relevant research available until 7 August 2020, in order to examine the autopsy findings of fatal scorpion stings
Summary
Scorpion sting is a public health issue in several countries, in America, the Middle. The segmented tail curves up dorsally, ending in the terminal bulbous segment called the telson, which contains paired venom glands and the aculeus (stinger) [17]. Their origin is dated to approximately 450 million years ago, since when they divided into 19 recognized families and more than 2200 species [18]. It is estimated that about 50 species from the families of Buthidae, which includes the genera Leiurus in the Near and Middle East, Androctonus and Buthus in North Africa, Tityus in South America, Centruroides in North and Central America, Healthcare 2020, 8, 325; doi:10.3390/healthcare8030325 www.mdpi.com/journal/healthcare. While species like Centruroides and Parabuthus cause neuromuscular issues, Buthus, Mesobuthus and Androctonus exhibit life-threatening cardiovascular effects [21]. The purpose of this literature review is to evaluate the autopsy findings in scorpion sting-related deaths in order to better evaluate the post-mortem evidence in those cases
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