Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation?

Castillo, Austin; Attaluri, Pradeep

doi:10.12746/swrccc.v6i22.435

Cited by 4 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common symptoms of a scorpion sting are nausea, vomiting, nystagmus, mydriasis, hypersalivation, dysphagia and restlessness. Death usually occurs due to causes such as: cardiovascular failure, respiratory failure, anaphylactic shock, bronchoconstriction, bronchorrhea, pharyngeal secretions, diaphragmatic paralysis and multiorgan failure ( 47 , 60 , 71 , 72 ). The clinical manifestations have been observed in children with the same adult symptoms but more severely and over a longer period.…”

Section: Discussionmentioning

confidence: 99%

Toxicity Mechanism of Dangerous Scorpion Stings in Iran

Dehghani,

Ghorbani,

Varzandeh

et al. 2023

JAD

View full text Add to dashboard Cite

Background: Considering the importance of scorpions and recognizing the mechanisms of toxicity caused by their medically important species in Iran and adopting the best therapeutic approach based on these mechanisms, this study was performed by reviewing the clinical manifestations of scorpion stings. Methods: The research was conducted by searching for articles and researches in related websites (PubMed, EMBASE, Scopus, Web of Science and CINAHL) and using domestic and international authoritative journals using the keywords of scorpion, clinical manifestations, in a review method. Finally, 104 qualified sources were selected and after reviewing and criticizing these studies, the author's point of view was presented. Results: Clinical manifestations of Scorpion sting toxicity vary due to the existence of two toxic classes of neurotoxins and cytotoxins or hemotoxins in these arthropods in Iran. The number and distribution of species with neurotoxic venom are higher than the scorpions with cytotoxic venom and are reported throughout Iran. Scorpions with cytotoxic venom are mostly widespread in south and southwest of Iran. Conclusion: Treatment and prevention of scorpion stings in Iran and neighboring countries in the Middle East should be planned based on the mechanism of toxicity and the presence of toxic classes with neurotoxic or cytotoxic venoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Toxicity Mechanism of Dangerous Scorpion Stings in Iran

Dehghani,

Ghorbani,

Varzandeh

et al. 2023

JAD

View full text Add to dashboard Cite

show abstract

“…Venom-induced and antivenom-induced anaphylaxis should be considered in these patients since some symptoms of anaphylaxis can overlap with symptoms of severe systemic envenomation [126][127][128][129]. Furthermore, adrenergic storm in severe envenomations can mask the symptoms of anaphylaxis or even protect against it [126,130].…”

Section: Clinical Take-home Messagementioning

confidence: 99%

Scorpion envenomation-associated myocarditis: A systematic review

et al. 2023

View full text Add to dashboard Cite

Background Scorpion envenomation is associated with several complications. One of the most serious complications is the cardiac involvement in the form of myocarditis that remains the main reason for mortalities associated with scorpion envenomation. The present review aims to elucidate clinical and paraclinical findings associated with scorpion-related myocarditis, and to explore different management strategies and subsequent outcomes. Methods We searched PubMed, Web of Science, Scopus, and Google Scholar for articles related to keywords of myocarditis associated with scorpion envenomation up to May 1, 2022. Each article was carefully reviewed by two independent researchers. In case of disagreement for inclusion, we sought a third researcher opinion. Results A total of 703 cases from 30 case reports and 34 case series were included in our review. Myocarditis associated with scorpion envenomation was usually reported in children presenting with cardiopulmonary symptoms including pulmonary edema (60.7%) and shock or hypotension (45.8%). The most common ECG findings are sinus tachycardia (82%) followed by ST-T changes (64.6%). The management typically included inotropes (especially dobutamine), prazosin, diuretics, nitroglycerine and digoxin, when indicated. Mechanical ventilation was required in 36.7% of the patients. Mortality in confirmed scorpion-related myocarditis cases is estimated at 7.3%. Almost all survived cases showed rapid recovery and improvement in the left ventricular function. Conclusion Even though myocarditis associated with scorpion envenomation is rare, it remains a serious and in some of cases a fatal consequence of scorpion sting. In case of relative presentations, particularly in envenomed children, diagnosis of myocarditis should be considered. Early screening using serial cardiac markers and echocardiography can guide the treatment. Prompt treatment that focuses on cardiogenic shock and pulmonary edema usually results in a favorable outcome.

show abstract

“…3 Deaths from scorpion stings are usually due to pulmonary edema and cardiogenic shock, whereas post-sting anaphylactic shock can also cause mortality. 1,5 The type, age, and size of the scorpion, nutritional status, number of stings, venom injection depth, the sting being located closer to the head and neck, and age and health status of the patient may affect the clinical course. 6 Scorpion venoms are mixtures of many biologically active components, some of which are hemolysins and neurotoxins; the latter often act on ion channels.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study

Turgut

Yavuz

Gülaçtı

et al. 2022

Wilderness & Environmental Medicine

View full text Add to dashboard Cite

Introduction-After a scorpion sting, patients commonly present to hospitals with pain. Our study sought to compare the analgesic efficacy of IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo in patients reporting pain after presenting with a history of scorpion sting.Methods-This double-blind, randomized, placebo-controlled study was conducted in the emergency department of a tertiary hospital. Adult patients who presented with the complaint of pain after a scorpion sting and did not have systemic findings were randomly assigned to 1 of the following 4 groups: IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo. The visual analog scale scores were measured at the time of presentation to the emergency department and at 30 and 60 min to determine the pain intensity.Results-The study included 106 patients, of whom 30 were in the paracetamol group, 26 in the dexketoprofen trometamol group, 25 in the topical lidocaine group, and 25 in the placebo group. We did not find a different analgesic effect among the groups in the first 30 min (P=0.185). IV paracetamol, dexketoprofen trometamol, and topical lidocaine did not show different analgesic effects in the first 60 min (P>0.05). IV paracetamol and dexketoprofen trometamol were found to provide a more effective analgesia than the placebo at 60 min (P<0.05). The analgesic effects of topical lidocaine and placebo did not differ (P=0.330).Conclusions-IV paracetamol and IV dexketoprofen trometamol provided analgesia in the first 60 min, similar to topical lidocaine but superior to placebo.

show abstract

Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation?

Cited by 4 publications

References 10 publications

Toxicity Mechanism of Dangerous Scorpion Stings in Iran

Toxicity Mechanism of Dangerous Scorpion Stings in Iran

Scorpion envenomation-associated myocarditis: A systematic review

Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study

Contact Info

Product

Resources

About