ECMO FOR THE TREATMENT OF MODS DUE TO ORAL SCORPION TOXICOSIS: A CASE REPORT

Abstract

TYPE: Abstract Publication TOPIC: Cardiovascular Disease PURPOSE: Scorpion sting poisoning kills 3,000 people worldwide every year. However, multiple organ dysfunction syndrome (MODS) induced by oral scorpion venom is rarely reported. Using extracorporeal membrane oxygenation (ECMO) as a treatment for scorpion poisoning has not been reported. METHODS: The purpose of this report was to describe a case of oral scorpion toxicosis observed in Shanghai, China, in a 64-year-old man with "arthritis". The patient rapidly developed toxic myocarditis, liver injury, renal injury and polyserositis due to the neurotoxic activity of the venom. Cardiomyopathy that can lead to fatal acute heart failure is a risk after scorpion toxicosis. Decreased blood pressure, pulmonary wedge pressure >20 mmHg, cardiac index <2.0 L/min/m2, urine output <20 ml/h, metabolic acidosis, and hyperlactacidaemia, even if not improved with large-dose positive vasoactive agents, all indicate severe scorpion toxicosis, and the condition requires close patient monitoring and symptomatic treatment using ECMO. Notably, plasmapheresis treats progressive bilirubin elevation, and continuous renal replacement therapy treats acute renal failure. With aggressive medical management, the patient recovered within a few days. RESULTS: We presented this case because of its unusual clinical presentation, unexpected complications, and prompt resolution. CONCLUSIONS: It is particularly important to clarify the medical history, diagnosis and use of multiple organ support treatment for scorpion poisoning as soon as possible to reduce the death rate. CLINICAL IMPLICATIONS: It is particularly important to clarify the medical history, diagnosis and use of multiple organ support treatment for scorpion poisoning as soon as possible to reduce the death rate. DISCLOSURE: No significant relationships. KEYWORDS: ECMO, MODS, scorpion toxicosis