Scorpion Envenomation Research Articles

Severe scorpion envenomation: pathophysiology and the role of inflammation in multiple organ failure.

Scorpion stings occur on every continent except Antarctica. The correlation between young age and severity of clinical manifestations after this envenomation is well-established. Several studies have emphasized the relevance of pro-inflammatory mediators in the pathophysiological manifestations of human scorpion envenomation. Moreover, there is a significant association between pro-inflammatory cytokine levels in the blood and the severity of scorpion envenomation. Release of these cytokines increases the severity of the visceral damage induced by the direct action of the venom and the activation of both the sympathetic and parasympathetic nervous systems.

Scorpion Sting Envenomation

Scorpion sting envenomation is very common problem in rural India especially where the climate is hot and dry. Management techniques have improved tremendously over the time leading to reduced morbidity and mortality. Mortality is mainly when ignorant patients go to the traditional faith healers (Tantrics) and come late to the facility where better management is available. Indian red scorpion (Mesobhuthustamulus) is the main species in India. Autonomic storm caused by venom acting on sodium gated and other channels is the main cause of manifestations in a scorpion sting victim. Cardio-myopathy is the main cause for morbidity and mortality. Many grading systems have been suggested for categorizing and simplifying the treatment. The mainstay of treatment where systemic involvement is there are alpha-1 blocker Prazosin hydrochloride, Fluids and newly arrived purified anti-venom. Scorpion envenomation being a problem of rural remote areas and most patients being from lower socio-economic status, anti-venom use is limited. Hence the treatment of choice remains Prazosin hydrochloride. Risk factors, peculiarities of presentation and dose titration of Prazosin based on severity will be discussed as per personal experience and literature review.J Nepal Paediatr Soc 2016;36(3):284-287

Age-Related Changes in Inflammatory Response after Experimental Envenomation: Impact on the Susceptibility to Androctonus australis hector Venom.

In regions at risk of scorpion envenomation, children remain the principal victims; they exhibit severe symptoms and represent a higher mortality rate compared to adults. The pathophysiology of envenomation is related to an excessive inflammatory response; however, no studies have identified the differences in immune responses to scorpion stings and mainly the mechanisms of inflammation between children and adults, which may be a determinant key of the susceptibility of children to scorpion envenomation. In this study, we compared the systemic (blood and lung) and the central (brain) inflammatory responses after injection of Androctonus australis hector (Aah) venom to 7 and 21 postnatal days (pnds) and adult mice by subcutaneous route. Results revealed that 7 and 21 pnd mice were more sensitive to Aah venom than adults and presented also severe systemic and central inflammatory responses characterized by a high activation of immune cells, NO liberation, and lipid peroxidation. Lymphocyte levels were much lower in young animals than in adults; however, neutrophil levels seemed to be higher in immature mice. The antioxidant GSH and catalase levels were more reduced in 7 and 21 pnd mice compared to adults leading to more pronounced tissular alterations and edema formation in lung and brain. These findings show a relationship between the severity of the pathophysiological effects of Aah venom and the age. The vulnerability of immature animals to Aah venom might result from uncontrolled inflammatory response and central nervous system alterations. Data from the present study emphasize the need for the development of age-specific therapeutic modalities.

Management of scorpion envenoming: a systematic review and meta-analysis of controlled clinical trials

BackgroundScorpion stings cause an estimated 3000 deaths per annum worldwide. We conducted a systematic review of all controlled clinical trials related to scorpion sting management.MethodsWe searched PubMed, EMBASE, Scopus, Web of Science and CINAHL and included controlled prospective clinical trials (randomized or non-randomized). The following interventions were assessed: adults and children with scorpion stings treated with (a) steroids vs. placebo, (b) different methods of pain relief, (c) antivenom vs. supportive treatment, (d) prazosin vs. supportive treatment, (e) antivenom vs. prazosin and (f) antivenom plus prazosin vs. prazosin alone. When trials had comparative outcomes, they were combined in a meta-analysis. Data was analysed with Review Manager 5. Dichotomous data were compared with relative risk (RR), and continuous data were compared with mean differences using a fixed effect model. There is no PROSPERO registration number for this study.ResultsAntivenom against Centruroides sp. are effective in reversing the clinical syndrome faster than no antivenom treatment in children (RR, 0.02; 95% CI, 0.01 to 0.06; 322 participants; three trials). Antivenom (against Mesobuthus tamulus) and prazosin combination is better than prazosin alone for faster resolution of symptoms (mean difference, −12.59 h; 95% CI, −14.01 to −11.17; 173 participants; three trials).ConclusionsThe polyvalent antivenom against Centruroides sp. in USA/Mexico and the monovalent antivenom against M. tamulus in India are effective for rapid resolution of symptoms. Prazosin is useful as an add-on therapy for M. tamulus stings.

Neurologic Complications in Children With Scorpionism: A Retrospective Study in Upper Egypt.

Scorpion envenomation is a life-threatening health problem in tropical and subtropical regions, particularly among children. The aim of this study was to describe the epidemiologic characteristics, clinical profile, and prognosis of neurologic complications among children with scorpionism in Upper Egypt. In this retrospective study, the neurologic complications of scorpionism in 2 university hospitals were analyzed from the points of epidemiologic and clinical picture and outcomes. The neurologic manifestations were found at a high percentage (85%). Irritability was the main manifestation (83.4%), followed by sweating (81.5%), hyperthermia (33.6%), and priapism (48.2% of males). Moreover, convulsion and coma were found in 14.7% and 11% of children, respectively. Neurologic manifestations were common in children with scorpionism and they correlated with poor outcome. Identification of epidemiologic and clinical features of central nervous system complications of scorpionism in children provide important data, helping in development of management policies aiming at preventive control of scorpionism and decrease its mortality.

Role of some vasoactive mediators in scorpion envenomed children: Possible relation to envenoming outcome

Scorpion envenomation causes an autonomic storm resulting in changes in the vasoactive mediators’ levels which lead to myocardial damage, cardiovascular disturbances, peripheral circulatory failure, pulmonary edema, multi-system-organ-failure and death. The study aimed to determine the circulating levels of adrenaline, noradrenaline, angiotensin converting enzyme (ACE), Angiotensin II (Ang II), kallikrein enzyme, nitric oxide (NO), aldosterone, and electrolytes Na+, K+ and Ca+2 in scorpion envenomed children and to evaluate the potential relation between these vasoactive mediators, the severity of scorpion envenoming and the clinical outcome of envenomed children. Forty envenomed children (22 mild and 18 severe cases) along with 10 healthy control children were enrolled in the study. The circulating levels of adrenaline, noradrenaline, Ang II, ACE, kallikrein enzyme, and NO were determined by ELISA, and spectrophotometric assays on admission and 24 h later. On admission, serum aldosterone, and electrolytes; Na+, K+ and Ca+2 were determined by RIA, Flame photometer and Flame atomic absorption respectively. All envenomed children showed significant surge of adrenaline, noradrenaline, ACE, Ang II, aldosterone, NO and Na+, that concomitantly faced by significant reduction in kallikrein, K+ and Ca+2 on admission. Twenty four hours later, all envenomed children continued to show significant elevation of ACE, Ang II and NO. The severely envenomed children showed considerable reduction in circulating levels of adrenaline, noradrenaline, ACE and Ang II, while dramatic increase in kallikrein activity was reported in comparison to mildly envenomed children after 24 h of medical care. Also, NO exhibited considerable accumulation in non survivors, on admission, that was persistent for the subsequent 24 h and was accompanied by high kallikrein, low catecholamines and Ang II levels compared to survivors. Finally, the hypertensive cases showed substantial higher levels of catecholamine, ACE and Ang II, 24 h after admission. These findings indicated that, disturbances of the studied vasoactive mediators were common in scorpion envenomed children and may account for several inflammatory manifestations and clinical outcome. ACE inhibitors could be considered as possible therapeutic agent in victims with prominent increase in ACE and Ang II while kallikrein inhibitor and antioxidants may be effective in the treatment of late hypotensive ones.

Selected scorpion toxin exposures induce cytokine release in human peripheral blood mononuclear cells

A cytokine screening on human peripheral blood mononuclear cells (PBMCs) stimulated with selected scorpion toxins (ScTx's) was performed in order to evaluate their effect on human immune cells. The ScTx's chosen for this report were three typical buthid scorpion venom peptides, one with lethal effects on mammals Centruroides suffussus suffusus toxin II (CssII), another, with lethal effects on insects and crustaceans Centruroides noxius toxin 5 (Cn5), and one more without lethal effects Tityus discrepans toxin (Discrepin). A Luminex multiplex analysis was performed in order to determine the amounts chemokines and cytokines IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12-p40, IL-13, interferon alpha (IFN-α), interferon gamma (IFN-γ), tumor necrosis factor alpha TNF-α, and interferon-inducible protein-10 (IP-10) secreted from human PBMCs exposed to these toxins. Although, the ScTx Cn5 is not lethal for mammals, it was able to induce the secretion of cytokines IL-1β, IL-6, and TNF-α, IL-10 and IP-10 in comparison to the lethal CssII, which was able to induce only IP-10 secretion. Discrepin also was able to induce only IP-10. Interestingly, only low amounts of interferons α and β were induced in the presence of the ScTx's assayed. In a synergic experiment, the combination of Discrepin and Cn5 displayed considerable reverse effects on induction of IL-1β, IL-6, IL-10 and TNF-α, but they had a slight synergic effect on IP-10 cytokine production in comparison with the single effect obtained with the Cn5 alone. Thus, the results obtained suggest that the profile of secreted cytokines promoted by ScTx Cn5 is highly related with a cytokine storm event, and also it suggests that the mammalian lethal neurotoxins are not solely responsible of the scorpion envenomation symptomatology.

Epidemiological and clinical characteristics of scorpionism in Shiraz (2012-2016); development of a clinical severity grading for Iranian scorpion envenomation

Background: Scorpionism is a public health problem in some provinces in Iran. The present study aimed to assess the clinical manifestations of scorpion envenomation in Shiraz and determine a clinical severity grading for Iranian scorpion envenomation in order to suggest a treatment guideline for emergency physicians. Methods: In this analytic retrospective study, all medical charts of patients with scorpion sting admitted in the adult medical toxicology center in Shiraz during July 2012 to July 2016 were assessed. Data regarding the patient's age, gender, sting site, month of envenomation, time of sting, clinical manifestations, vital signs, presence of blood or hemoglobin in urine analysis, duration of admission, color of scorpion, received treatments, and administration of scorpion antivenin were recorded. Results: The scorpions in Shiraz and its suburban area were classified into two groups: yellow scorpions ( Mesobuthus eupeus, Mesobuthus caucasicus , and Compsobuthus matthiesseni) and Hottentotta scorpions (Hottentotta jayakari and Hottentotta zagrosensis). A total of 126 cases of scorpion stings were assessed. About 59% (n=74) were males. The patients aged 8-63 years (mean age, 33.8±11.5 years). About 38.4% (n=48) of the stings occurred during summer. More than 40% of patients (n=51) referred to the emergency department (ED) at night. Localized pain was the most frequent presenting complaint (76.2%). The most frequent general symptom was nausea (6.3%). The most prevalent envenomation site was the lower extremities followed by upper extremities (43.5% and 41.9%, respectively). Based on the clinical severity grading for Iranian scorpion envenomation, 65, 43, and 18 patients (51.6%, 34.1%, and 14.3%) were classified in the grades I, II, and III, respectively. Eighty-one (73%) patients stayed in the ED from 1 to 6 hours, and 30 (27%) patients stayed for >6 hours for observation. Severe localized pain was more prevalent in stings with Hottentotta scorpions than yellow scorpions (P=0.01). The season of envenomation with Hottentotta scorpions was summer in all cases, but envenomation with yellow scorpions was seen throughout the year. All patients received symptomatic treatment, and five were given scorpion antivenin. No death was reported. Conclusion: Hottentotta jayakari is recommended to be listed among the medically important scorpions in Iran. Moreover, scorpion-stung patients in geographical regions where Hemiscorpius lepturus and Androctonus crassicauda are not prevalent may be treated in outpatient departments. The presented grading system can be used for treating patients with scorpion envenomation.

Consequences of Androctonus mauretanicus and Buthus occitanus scorpion venoms on electrolyte levels in rabbits.

Androctonus mauretanicus (A. mauretanicus) and Buthus occitanus (B. occitanus) scorpions, which belong to the Buthidae family, are the most venomous scorpions in Morocco. For the first time, we investigated the effects of such scorpion venoms on serum electrolytes in subcutaneously injected rabbits. For this purpose, 3 groups of 6 albinos adult male rabbits (New Zealand) were used in this experiment. Two of the groups were given a single subcutaneous injection of either crude Am venom (5 μg/kg) or Bo venom (8 μg/kg) whereas the third group (control group) only received physiological saline solution (NaCl 0.9%). The blood samples were collected from injected rabbits via the marginal vein at time intervals of 30 min, 1 h, 2 h, 4 h, 6 h and 24 h after venom injection. The concentrations of electrolytes in the serum samples were measured. Our study indicates that scorpion envenomation in vivo, rabbit animal model, caused severe and persistent hypomagnesaemia and hypochloremia, which are accompanied of hypernatremia, hyperkalemia and hypercalcaemia. The intensity of electrolytes imbalance was clearly superior in the case of A. mauretanicus scorpion venom (although a lower quantity of venom was injected). This is coherent with the experimental data which indicate that A. mauretanicus venom is more toxic than B. occitanus venom.

Pathophysiology of dilatation of pupils due to scorpion and snake envenomation and its therapeutic value: Clinical observations.

Dilated nonreacting pupils are routinely taken as a sign of irreversible brain damage. Alpha-receptor stimulation (scorpion sting) and presynaptic acetylcholine receptor blocker (krait bite) may result in dilation of pupils without involvement of the brain. This study was aimed to clinically evaluate the response of pupils in scorpion sting and krait bite. Victims of scorpion sting and krait bite were chosen from Raigad district. Scorpion sting and krait bite cases were admitted to hospital and were clinically evaluated in detail regarding neurological manifestations. Both cases had nonreacting dilation of pupils, complete neurological recovery accompanied with reverse of pupillary size and its response to light. In scorpion sting and krait bite poisoning, dilated nonreacting pupils are not the signs of irreversible brain damage.

Cardiac magnetic resonance study of scorpion toxic myocarditis.

Scorpion envenomation may represent a life-threatening condition and, specifically in tropical, subtropical and sub-Saharan area, will be considered a public health problem. We describe a case of a 25-year-old Caucasian woman, suffering from severe scorpion envenomation by Leirus Quinquestratius . The patient presented a catecholamine induced myocarditis and myocardial dysfunction. Our observations, obtained by repeated cardiac magnetic resonance (CMR) assessments (11 days; 3, 9 and 15 months), firstly revealed a possible irreversible and sub-clinical myocardial damage. CMR seems to be a useful tool to assess cardiac damage in scorpion envenomation, particularly in terms of prevention of irreversible myocardial damage and dilated cardiomyopathy delayed …

Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015.

Previous studies of scorpion envenomation in the United States (US) have focused on Arizona and the bark scorpion, Centruroides sculpturatus. Although many other scorpion species live in the US, information about envenomations in other states is lacking. Nationwide scorpion exposures from 2005 to 2015 were analyzed using the National Poison Data System. Of the 185,402 total exposures, Arizona (68.2%), Texas (10.3%), and Nevada (4.2%) were the top contributors. However, six other southern states reported greater than 100 cases annually, primarily during the warmer months and evening hours. Envenomations occurred most often in a home (97.8%) and were typically managed on-site (90.1%). Pain was the most common effect nationwide (88.7%). Arizona had the highest frequencies of sensory, neuromuscular, and respiratory effects along with higher hospitalization and ICU admission rates, although the latter appeared to drop over the study period. In contrast, local skin effects such as erythema and edema were more common outside of Arizona. Children under 10years of age in Arizona and Nevada had the highest rates of systemic effects, hospitalization, and ICU admission. Scorpion envenomations occurred throughout the southern US with similar seasonal and daily variations. Common clinical effects included pain, local edema, and erythema, except in Arizona and Nevada where severe systemic symptoms were more common. Systemic effects correlated with high rates of ICU admissions and intubations, especially in children under 10years of age.

Cost Minimization Analysis of Different Strategies of Management of Clinically Significant Scorpion Envenomation Among Pediatric Patients.

Scorpion antivenom was recently approved for use in patients with clinically significant scorpion envenomation in the United States; no formal economic analysis on its impact on cost of management has been performed. Three different strategies of management of scorpion envenomation with systemic neurotoxic symptoms in children were compared for cost minimization from a societal perspective. In strategy I, patients were managed with supportive care only without antivenom. In strategy II, an aggressive strategy of full-dose antivenom (initial dose of 3 vials with the use of additional vials administered 1 vial at a time) was considered. In strategy III, a single-vial serial antivenom dosing strategy titrated to clinical response was considered. Clinical probabilities for the different strategies were obtained from retrospective review of medical records of patients with scorpion envenomation over a 10-year period at our institution. Baseline cost values were obtained from patient reimbursement data from our institution. In baseline analysis, strategy I of supportive care only with no antivenom was least costly at US $3466.50/patient. Strategy III of single-vial serial dosing was intermediate but less expensive than strategy II of full-dose antivenom, with an incremental cost of US $3171.08 per patient. In a 1-way sensitivity analysis, at a threshold antivenom cost of US $1577.87, strategy III of single-vial serial dosing became the least costly strategy. For children with scorpion envenomation, use of a management strategy based on serial dosing of antivenom titrated to clinical response is less costly than a strategy of initial use of full-dose antivenom.

Modelling the scorpion stings using surveillance data in El Bayadh Province, Algeria

ObjectiveTo examine some epidemiological features of scorpion envenomations, analyse and interpret the recorded data, find any relationship between the incidence of scorpion stings and climatic factors, and finally develop a statistical model to estimate the variability among future cases in El Bayadh Province, Algeria. MethodsTo assess the effects of climate variability on the scorpion envenomations, we applied the count data regression models to the monthly recorded scorpion stings in El Bayadh Province from 2001 to 2012. ResultsThe epidemiological analysis of data revealed that scorpion stings occured mainly in rural areas, round the clock, all year long with the highest seasonal incidence in summer, and the lowest in winter, all ages with male predominance. The ends of upper and lower limbs were the most affected parts of the human body. The majority of cases (95.7%) were classified as mild envenomations and systemic toxicity was observed in 4.3% of cases. The use of count data regression models showed that the negative binomial regression was appropriate to forecast cases and the fitted data agreed considerably with the actual data. Moreover, the model had predicted the monthly scorpion sting cases for the year of 2013, with satisfactory accuracy. ConclusionsThis study shows an optimism for forecasting scorpion stings by modelling and calibration with surveillance data and climate information. This knowledge could help to contain any unusual situation and assist health decision-makers to strengthen the prevention and control measures and to be in a state of readiness.

Development of a recombinant camelid specific diabody against the heminecrolysin fraction of Hemiscorpius lepturus scorpion

Scorpion sting is one of the most important problems in public health practice in many countries. Khuzestan yellow scorpion, scientifically known as Hemiscorpius lepturus, belongs to the family Hemiscorpidae, and is one of the most common and dangerous scorpions in Iran. Hemiscorpius lepturus scorpion has potentially cytotoxic venom. The first treatment for scorpion envenoming is horse antisera. Due to their unique characteristics, camels have been considered as an important source for antiserum and monoclonal antibody (Nanobody) production. In the previous study, we reported a specific nanobody against the hemolytic fraction (heminecrolysin) of Hemiscorpius lepturus venom. In the present study, a recombinant diabody was constructed and produced by fusion of two nanobodies. Results from in vitro and in vivo assays showed that the diabody has a promising ability to neutralize venom activity.

Saudi medicinal plants for the treatment of scorpion sting envenomation.

Scorpion sting envenoming poses major public health problems. The treatment modalities include antivenoms, chemical antidotes and phytotherapy, with varying degrees of effectiveness and side effects. In this investigation, we reviewed the use of Saudi medicinal plants for the treatment of scorpion sting patients. The relevant literature was collected using the online search engines including Science Direct, Google and PubMed with the help of specific keywords. We also used the printed and online resources at our institutional library to gather the relevant information on the use of medicinal plants for the treatment of scorpion sting patients. A descriptive statistics was used for data compilation and presentation. The results of this survey showed the use of at least 92 medicinal plants with beneficial effects for treating victims of stings of different scorpion species. These commonly used herbs spanned to 37 families whilst different parts of these plants were employed therapeutically for alleviation of envenomation symptoms. The application of leaves (41%) was preferred followed by roots (19%), whole plant (14%) and seeds (9%). The use of latex (4%), stem (3%), flowers (3%) and bark (3%) was also reported. In some cases, tannin (2%), rhizome (1%) and shoot (1%) were also used. In conclusion, herbal medicines are effectively used for the treatment of patients with scorpion envenomation. This type of medication is free from side effects as observed with chemical antidotes or antivenom therapy. It is important to identify the active ingredients of herbal drugs for improving their therapeutic potential in traditional medicine.

Forecasting and prediction of scorpion sting cases in Biskra province, Algeria, using a seasonal autoregressive integrated moving average model.

OBJECTIVESThe aims of this study were to highlight some epidemiological aspects of scorpion envenomations, to analyse and interpret the available data for Biskra province, Algeria, and to develop a forecasting model for scorpion sting cases in Biskra province, which records the highest number of scorpion stings in Algeria.METHODSIn addition to analysing the epidemiological profile of scorpion stings that occurred throughout the year 2013, we used the Box-Jenkins approach to fit a seasonal autoregressive integrated moving average (SARIMA) model to the monthly recorded scorpion sting cases in Biskra from 2000 to 2012.RESULTSThe epidemiological analysis revealed that scorpion stings were reported continuously throughout the year, with peaks in the summer months. The most affected age group was 15 to 49 years old, with a male predominance. The most prone human body areas were the upper and lower limbs. The majority of cases (95.9%) were classified as mild envenomations. The time series analysis showed that a (5,1,0)×(0,1,1)12 SARIMA model offered the best fit to the scorpion sting surveillance data. This model was used to predict scorpion sting cases for the year 2013, and the fitted data showed considerable agreement with the actual data.CONCLUSIONSSARIMA models are useful for monitoring scorpion sting cases, and provide an estimate of the variability to be expected in future scorpion sting cases. This knowledge is helpful in predicting whether an unusual situation is developing or not, and could therefore assist decision-makers in strengthening the province’s prevention and control measures and in initiating rapid response measures.

Clinical Characteristics of Pediatric Scorpion Envenomation in the Aegean Region: An Experience of a Training and Research Hospital

Clinical Characteristics of Pediatric Scorpion Envenomation in the Aegean Region: An Experience of a Training and Research Hospital

Clinical Presentation and Outcomes Associated with Different Treatment Modalities for Pediatric Bark Scorpion Envenomation.

Scorpion envenomation is potentially life-threatening and affects children in the Southwestern USA. An FDA-approved antivenom is available, but its high cost has led to use of off-label antivenom dosing or supportive care alone as alternatives to FDA-recommended dosing. This study sought to determine whether treatment approach influences outcomes in envenomated children. A retrospective cohort study of children with grade III or IV scorpion envenomation evaluated in Phoenix Children's Hospital ED between September 1, 2011, and March 31, 2014. Patients were grouped based on treatment: group 1, supportive care only; group 2, FDA-recommended dosing (3-vial initial dose); group 3, "off label" dosing (1-2 vial initial dose). Primary outcomes were ED length of stay and hospital admission. Secondary outcomes were mechanical ventilation and aspiration pneumonia. One hundred fifty-six patients were included with 58 patients in group 1, 16 patients in group 2, and 82 patients in group 3. Group 1 was significantly older than the antivenom groups (p<0.001), and group 2 was younger than group 3 (p=0.024). Envenomation grade was also different, with group 1 having fewer grade IV then groups 2 and 3 (p<0.001). Three percent of group 1, 56% of group 2, and 28% of group 3 had respiratory distress (p<0.001). ED LOS was not significantly different between groups. Hospital admission occurred in 3.4% group 1, no group 2, and 8.5% group 3 patients. Two intubations and two aspirations occurred in group 3. In this study, clinical presentation appeared to influence treatment. Groups that received antivenom had a higher envenomation grade than the group that received supportive care. The FDA-recommended dosing group was younger and had more respiratory distress than those treated with initial doses of 1-2 vials. Outcomes were not significantly different between groups. Prospective studies may identify the ideal population for each treatment approach.

Spatial distribution of scorpions according to the socioeconomic conditions in Campina Grande,State of Paraíba, Brazil

Due to its frequency and morbidity, such as that caused by scorpions have achieved public health importance in certain regions of the world. The present exploratory ecological study aimed to characterize the epidemiological profile and spatial distribution of scorpion stings in Campina Grande, State of Paraíba in Northeastern Brazil. Geographical information system techniques were used to record the scorpion stings, and Google Earth software, Track Maker, and ArcGIS 10 Esri were used as geocoding databases. The Moran test was used to evaluate spatial correlation, and the Pearson chi-square test was used to analyze associations between scorpion stings and socioeconomic variables. The study evaluated 1,466 scorpion stings. Envenomations were more frequent among women (n = 908, 61.9%), and most patients were aged 13-28 years (n = 428, 29.2%). The Southern region of the city had the largest number of registered cases (n = 548, 37.4%), followed by the Western region (n = 510, 34.8%). Spatial analysis of scorpionism revealed an irregular occurrence in Campina Grande. Further, no association was observed between the socioeconomic factors analyzed and the geographic location of the scorpion envenomations. Detection of spatial areas with an increased risk of scorpionism can help prioritize adoption of preventive measures in these regions to reduce the associated incidence and morbidity.