Abstract
Objective: Scorpion stings are common in tropical regions of Iran. Hemiscorpius enischnochela are distributed in southern part of Iran. The venom of this scorpion causes severe hemolysis, hemoglobinuria, and occasionally death. Case Presentation: This report describes the clinical manifestations of envenomation by H. enischnochela in a 3-year-old boy from Ruydar city in south of Iran. Conclusion: Special attention should be paid to the painless stings of yellow scorpions and more studies are needed to set out a protocol for the management of these cases in areas with this envenomation to be a common one
Highlights
Scorpion stings and envenomation are common dilemma in the Middle East [1]
In south-western Iran, most of the mortalities of the scorpion envenomation are associated with H. lepturus stings [13]
They reported that partial thromboplastin time (PTT), Prothrombin time (PT), hemoglobin (Hb), red blood cell (RBC), and platelet (PLT) counts should be considered as important indicators in H. lepturus envenomation [17]
Summary
Scorpion stings and envenomation are common dilemma in the Middle East [1]. Scorpion venom contains various substances such as neurotoxins, cardiotoxins, nephrotoxins and hemolytic toxins [2]. Systemic: due to the increased release of the acetylcholine and catecholamines: drowsiness, irritability, restlessness, decreased level of consciousness, seizure, miosis, tachypnea, excessive sweating, salivation, diarrhea, nausea, vomiting, urination, severe abdominal cramps, priapism, limb numbness, blurred vision, tachycardia, hypertension, hyperthermia, filiform pulse, hypotension, hypothermia, cool extremities, decreased tendon reflexes, cyanosis, excessive thirst, ECG changes, ARDS, melena, bloody vomiting Laboratory: leukocytosis, granulocytosis, lymphopenia, glucosuria, hemoglobinuria, proteinuria, mild increased PT, PTT and INR, hypocalcemia. Pale, and symptom-free on the first day of admission He received three vials (IV) of scorpion antivenin (because of the suspicion of Gadim stings) [12]. During ICU admission the patient received three more intravenous (IV) scorpion antivenin vials, urinary alkalization, IV hydrocortisone, IV clindamycin, packed cell, prazocin (PO), platelet (IV), acetaminophen (PO), and intramuscular tetabulin.
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