Scorpion Sting and Envenomation

Abstract

Scorpion stings are a major public health problem in many underdeveloped tropical countries, especially Sahelian Africa, South India, the Middle East, Mexico, and South Latin America. Although there are various species of scorpions, only few of these can be potentially lethal to humans. Scorpion venoms consist of a complex of several toxins that exhibit a wide range of biological properties and actions. The venom is variable in chemical compositions, toxicity, and pharmacokinetic and pharmacodynamic characteristics. The envenoming is associated with high morbidity and mortality, especially among children. Victims having envenomed by a scorpion suffer a variety of pathologies, including mainly both sympathetic and parasympathetic stimulation and central manifestations such as irritability, hyperthermia, vomiting, profuse salivation, tremor, and convulsion. Envenoming by scorpion can result in a variable range of clinical features, including cardiotoxicity, neurotoxicity, and respiratory dysfunction. Many health-care providers are unaware of the effects of their stings and scorpions are often feared based on their fatal reputation. Treatment regimen including scorpion antivenom and vasodilators and intensive care management have been tried to alleviate the systemic effects of envenoming. Administration of anti-scorpion venom serum (AScVs) is the only specific treatment available but has many limitations like species specificity, difficulty in availability, affordability, and ideal storage conditions. In spite of advances in pathophysiology and therapy, mortality remains high in rural areas due to lack of access to medical facilities.