Scorpion Sting Cases Research Articles

An epidemiological study on scorpion stings in Lordegan County, south-west of Iran.

Scorpion sting is a common important health problem in south-west of Iran. The present descriptive retrospective study was conducted to make new information on scorpionism in the Lordegan County(2002- 2006). Data collected in this study revealed that the highest incidence of scorpion sting cases was taken place in spring (49.72%) in 2006. The scorpions which have brought by the pateints to the Lordegan health centre, were identified as Androctonus crassicauda, Hemiscorpius lepturus, Mesobuthus eupeus, Compsobuthus sp. and Scorpio maurus. The epidemiology data suggest injection antivenin of scorpions to the victims as a good way to reduce the scorpion mortalities and injuries in this area.

Scorpion Stings Presenting to an Emergency Department in Singapore With Special Reference to Isometrus Maculatus

We describe the epidemiology and clinical features of scorpion stings presenting to an emergency department in Singapore, including that of the venomous species Isometrus maculatus. A management approach to scorpion stings is proposed. A retrospective study was done for patients from 2004 to 2009. Cases were identified by searching through emergency department records with ICD code E905, inpatient records, and the hospital toxicology service records. Identification of species was assisted by the Venom and Toxin research program at the National University of Singapore. A total of 13 cases of scorpion stings were identified. Eleven stings occurred locally, and the remaining 2 stings occurred in neighboring countries. The most common presenting symptoms were pain (92%), numbness (31%), and weakness (23%) confined to the region of the sting. The most common clinical signs recorded were redness (77%), tenderness (77%), and swelling (46%). Only 2 patients had significant alterations of vital signs: 1 had hypertension and the other had hypotension from anaphylaxis. Three patients experienced complications (abscess formation, anaphylaxis, cellulitis) requiring inpatient management. There were no fatalities, and all patients made a good recovery. Three cases were identified to be stings from I maculatus. These cases occurred locally, and mainly had clinical features of pain, redness, and mild regional numbness. Scorpion stings are uncommon presentations to the emergency department. Most stings cause local reactions that can be managed with supportive treatment. Stings by I maculatus were observed to cause mild, self-limiting effects.

Scorpionism in Central America, with special reference to the case of Panama

Scorpionism in the Americas occurs mainly in Mexico, northern South America and southeast Brazil. This article reviews the local scorpion fauna, available health statistics, and the literature to assess scorpionism in Central America. Notwithstanding its high toxicity in Mexico, most scorpion sting cases in Guatemala, Belize, El Salvador, Nicaragua, and Costa Rica are produced by species in the genus Centruroides that are only mildly toxic to humans despite the existence of ion channel-active toxins in their venoms. Regional morbidity is low with the exception of Panama, where an incidence of 52 cases per 100,000 inhabitants was recorded for 2007, with 28 deaths from 1998 to 2006. Taxa belonging to the genus Tityus (also present in the Atlantic coast of Costa Rica) are responsible for fatalities in Panama, with Tityus pachyurus being the most important species medically. Most Tityus species inhabiting Panama are also found in northern South America from which they probably migrated upon closure of the Panamanian isthmus in the Miocene era. Incorporation of Panama as part of the northern South American endemic area of scorpionism is thereby suggested based on the incidence of these accidents and the geographical distribution of Panamanian Tityus species.

Evaluation of scorpion sting incidence in turkey

Scorpion stings are common in Turkey due to its geographical location, climate and socioeconomic structure. Scorpion envenomation cases are a considerable public health problem in all regions of the country. Important health-threatening scorpions in Turkey are Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus and M. eupeus, all of which belong to the Buthidae family. They are described to be potentially dangerous to humans. So far, there is no study about scorpion sting incidence covering all geographical regions of Turkey; therefore, in this study, we analyzed the frequency of scorpion sting cases in the country. A total of 24,261 scorpion sting cases were reported during 2005. Most of which (about 80%) occurred in the Southeastern Anatolia (30.4%), Mediterranean Sea (24.9%) and Aegean regions (23.5%), where medically important scorpion species are found. The sting cases mostly occurred during the summer period. Our results suggest that scorpion stings are an important problem in Turkey. This simple descriptive study will help develop interventions to prevent scorpion stings, which should take local sting cases into consideration.

Hemolytic uremic syndrome following Hemiscorpius lepturus (scorpion) sting

Scorpion envenomations are a public health problem in many countries. Scorpions are second only to snakes in causing human fatalities from envenomation. Species of scorpions capable of inflicting fatal stings are living in North and South Africa, the Middle East, India, America, Trinidad, and Tobago. Hemiscorpius lepturus (from the Hemiscorpiidae family) is the most medically important scorpion in Iran which accounts for 92% of all hospitalized scorpion sting cases. The venom from H. lepturus is primarily a cytotoxic agent and has hemolytic, nephrotoxic, and to some extent, hepatotoxic activities. We found a combination of microangiopatic hemolytic anemia, thrombocytopenia, and acute renal failure in a seven year-old female child who was referred to us with a 12 h history of bloody urine following a H. lepturus sting. Her blood smear showed fragmented erythrocytes and burr cells, leading us to a diagnosis of hemolytic uremic syndrome (HUS). This report highlights the importance of acceptable prophylaxis and therapeutic protocols for HUS in these patients.

Scorpion stings in Qassim, Saudi Arabia—A 5-year surveillance report

We reviewed and analyzed 5-year (1999–2003) surveillance data of scorpion stings in Qassim, Saudi Arabia. A total of 6465 scorpion sting cases were notified. Male-to-female ratio for scorpion stings was 1.9:1. The mean age for cases was 23±17 years and 3079 (47.8%) cases were between the ages of 11 and 30 years. The scorpion stings had a higher incidence in the months of May–October. This information is beneficial for health education and prevention of scorpion sting cases.

Antitoxin activity of plants used in Mexican traditional medicine against scorpion poisoning

Scorpions, especially in urban areas of tropical and subtropical regions, present a common risk of poisoning. In Mexico, scorpion envenomation is considered a public health problem. Despite the frequency of scorpion sting cases, there are to date no uniform criteria for their treatment. In Mexican traditional medicine, different plant species have been widely used as a remedy for treating scorpion poisoning. The aim of this work was to evaluate the effect of Bouvardia ternifolia, Aristolochia elegans and Vitex mollis extracts on Centruroides limpidus limpidus venom lethality in mice, and to determine their antagonist activity on guinea pig ileum. The hexane and methanol extract from B. ternifolia modified the LD50 of C. limpidus limpidus venom from 0.750 +/- 0.08 to 1.64 +/- 0.19 and 1.16 +/- 0.14 mg/kg, respectively. The extracts of A. elegans produced lower antitoxic activity, while extracts of V. mollis did not show any protection. On in vitro test, addition of B. ternifolia and A. elegans extracts strongly inhibited, in a concentration-dependent manner, the ileum contractions induced by venom. In general, the results demonstrated the effectiveness of these two plant species in modifying the lethality of C. limpidus limpidus venom in mice.

Implantation et analyse d'un registre des piqûres de scorpion au Maroc

Within the framework of a strategy against scorpion stings, an information system was established to track the indicators of morbidity and mortality caused by scorpion stings. The study of these indicators was carried out based upon a national record of scorpion stings. During the year 2001, 15,571 cases of scorpion stings were reported, that translates into an incidence rate of 1.2%. The patients were poisoned in 11.6% of the cases. Most of the patients (79.3%) were only put under clinical surveillance and did not receive any symptomatic treatment. The death rate was 6.3% and death only occurred in children of less than 15 years old (2.1% of the cases). This study demonstrated an improvement in morbidity and mortality indicators in comparison to the data collected before this campaign, all of which verifies the positive impact of the strategy which was put into place. However, it is necessary to continue monitoring until Morocco can overcome this problem.

Australian scorpion stings: a prospective study of definite stings

There is little information on scorpion stings in Australia. The aim of this study is to describe the circumstances and clinical effects of stings by Australian scorpions. Cases of scorpion stings were collected prospectively from calls and presentations to Australian poison information centres and emergency departments from February 2000 to April 2002. Only definite scorpion stings where the scorpion was immediately collected and expertly identified were included. There were 95 patients, 33 males and 62 females, with a mean age of 32 (SD 19.5; range 1–71) and 23 children (age<15 years). Three families of scorpions caused all stings: Buthidae (79), Bothruiridae (11, all Cercophonius spp.) and Urodacidae (five, all Urodacus spp.). The majority of stings (76%) were by one genus of scorpion Lychas spp. Seventy one percent of stings occurred between 6pm and 8am and 82 (86%) occurred indoors. Sixty percent of stings occurred on distal limbs. The median duration of effects was 6 h (interquartile range (IQR): 1–24 h). Immediate localised pain occurred in all cases and was severe in 76 cases (80%). Other local effects included red mark/redness (66%), tenderness (35%), numbness (12%) and paraesthesia (11%). Minor systemic effects (nausea, headache and malaise) occurred in 11% of cases. There were no deaths or major systemic envenoming. Less severe effects were observed for the larger Urodacus species, compared to Lychas spp. Scorpion stings in Australia do not appear to cause severe or life-threatening effects, even in children. This differs from other parts of the world, where severe envenoming is reported. The major clinical effect is severe pain, consistent with other scorpion stings. Most stings occurred indoors and at night.

Scorpion Envenomation in Children: Should All Stings Be Given Antivenom?

Scorpion Envenomation in Children: Should All Stings Be Given Antivenom?

Scorpion poisoning in the Acosta and Caripe Counties of Monagas State, Venezuela. part 1: characterization of some epidemiological aspects.

Scorpion poisoning was surveyed in Acosta and Caripe counties, located in the Turimiquire subregion of Monagas State, Venezuela, aiming to expand information on stings by characterizing some epidemiological aspects. From 1987 to 1993, 298 cases of scorpion stings were recorded in Acosta and Caripe counties. Acosta had 212 cases, with an annual incidence rate of 18.3 (cases per 10,000 inhabitants) and a period median incidence rate of 128 . The scorpion poisoning index is 4.18 times greater in Acosta than in Caripe, confirming the former as a hyperendemic zone for this type of injury, with a phenomenon of cyclical temporal fluctuations and an upward trend. This area is infested with scorpions of the genus Tityus. Our results show that the region surveyed in Monagas State is endemic for scorpion stings, posing a major public health problem.

Scorpion sting epidemiology in Montes Municipality of the State of Sucre, Venezuela: geographic distribution.

Scorpion stings were surveyed in the Montes Municipality of the State of Sucre, Venezuela, aiming to extend the information on these poisonous accidents by characterizing their geographic distribution. From 1980 to 1990, 184 cases of scorpion stings were recorded with an incidence rate of 38.6 cases per 10,000 inhabitants. The locality of San Fernando presented the highest incidence (68.3/1000) of poisonous accidents. The highest percentages of severe cases were recorded in the towns of Arenas (27%), San Lorenzo (21%), and Cocollar (19%), which are located at the foot of the Turimiquire Mountains. This region is a dispersion area of scorpions of the Tityus genus. Our results show that this region of the State of Sucre is endemic for scorpion stings which are an important public health problem.

Standardization of an enzyme linked immunosorbent assay (ELISA) for detecting circulating toxic venom antigens in patients stung by the scorpion Tityus serrulatus.

The sensitivity and specificity of an enzyme-linked immunosorbent assay (ELISA) for the detection of circulating antigens from toxic components of Tityus serrulatus scorpion venom was determined in patients stung by T. serrulatus before antivenom administration. Thirty-seven patients were classified as mild cases and 19 as moderate or severe cases. The control absorbance in the venom assay was provided by serum samples from 100 individuals of same socioeconomic group and geographical area who had never been stung by scorpions or treated with horse antisera. The negative cutoff value (mean + 2 SD) corresponded to a venom concentration of 4.8 ng/ml. Three out of the 100 normal sera were positive, resulting in a specificity of 97%. The sensitivity of the ELISA when all cases of scorpion sting were included was 39.3%. When mild cases were excluded, the sensitivity increased to 94.7%. This study showed that this ELISA can be used for the detection of circulating venom toxic antigens in patients with systemic manifestations following. T. serrulatus sting but cannot be used for clinical studies in mild cases of envenoming since the test does not discriminate mild cases from control patients.

Androctonus crassicauda (Olivier), a dangerous and unduly neglected scorpion—I. Pharmacological and clinical studies

Androctonus crassicauda venom has an i.v. LD50 in mice of 0.32±0.02 mg/kg, which makes the scorpion among the most toxic species in the world. Fifty-one non-fatal and one fatal cases of scorpion sting were presented. Pain and tenderness were very common following the sting. Generalized erythema occurred in 20–25% of all infants and children below the age of 5 years. Severe CNS manifestations including seizures, unconsciousness and marked irritability occurred mainly in infants and young children, while hypertension occurred in the majority of victims below the age of 11 years. Two pregnant victims were treated with antivenom with no bad consequences on mothers or foetuses. The fatal case described was inadequately treated with antivenom and presented a rare situation of intracranial coagulation in the basal cisterns or low in the cranial subarachnoid space. The victim developed moderate hydrocephalus of the communicating type with clear ventricular CSF and strongly xanthocromic fluid from lumbar puncture. The effects of A. crassicauda venom on isolated hearts, atria and anaesthetized rat blood pressure appeared to be mediated largely through stimulation of the autonomic nervous system with predominance of sympathetic stimulation and release of tissue catecholamines. Electrocardiograms recorded simultaneously with blood pressure changes showed evidence of ectopic foci during the hypertensive phase and ischaemia, inferior wall infarction and different degrees of heart block during the late hypotensive phase. Androctonus crassicauda venom was unique in following a three-compartment open model comprising a central compartment ‘blood’, a rapidly equilibrating ‘shallow’ tissue compartment and a slowly equilibrating ‘deep’ tissue compartment. The overall elimination half-life, t12β, was 24 hr, indicating that the venom has the slowest elimination among all known scorpion venoms. The long stay of the venom in the body might explain the increased risk of toxicity and the good potential for treatment with serotherapy even hours after the sting.

Stings by red scorpions ( Buthotus famulus) in Maharashtra State, India: a clinical study

Of 33 cases of scorpion sting admitted to hospital in Mahad, Maharashtra State, India, 10 had a mean blood pressure between 100 and 137 mm/Hg and 11 had a heart rate between 130 and 215 per min. Seven patients developed acute pulmonary oedema; there were 2 deaths. Three patients had local pain at the site of sting. The role of vasodilators such as prazosin hydrochloride, sodium nitroprusside and nifedipine were investigated in addition to digoxin, diuretics and aminophylline to alleviate refractory myocardial failure due to scorpion sting.

Epidemiological and clinical aspects of certain venomous animals of Spain

D. González. Epidemiological and clinical aspects of certain venomous animals of Spain. Toxicon 20, 925–928, 1982.—From 1965 to 1978, 300 cases of snakebites were recorded and from 1974 to 1978, 100 cases of scorpion stings, 5 of Scorpaena stings and 125 of Trachinidae stings. Antivenom therapy was the most effective treatment for severe viper bites, with antihistaminics and steroids for M. monspessulanus. Antihistaminics, steroids and anesthetics were most effective for scorpions and marine animals.