Clinical Effects and Predictive Factors Affecting the Clinical Severity of Scorpion Envenomations in Western Turkey

Abstract

Background Scorpion envenomation is a common medical emergency in many countries, including Turkey. Severe systemic symptoms occur more easily in children and mortality rates are higher. The aim of this study is to describe the clinical effects and predictive factors affecting the clinical severity of scorpion envenomations in Western Turkey. Methods Two hundred one children (138 mild cases, 34 moderate, and 29 severe) with scorpion envenomation aged between 1 month and −17 years were included in the study. The patients’ demographic and laboratory characteristics were compared among clinical severity subgroups. Results The patients’ median age was 7 (4–11) years. The median age of the severe group was significantly lower than that of the mild and moderate groups (p < 0.001). Seventeen patients (8.5%) developed myocarditis, while no pulmonary edema was observed in any case. Leukocyte, neutrophil and platelet (PLT) counts, and plateletcrit (PCT) and glucose levels increased significantly with the severity of envenomation (p < 0.001). PLT counts and PCT levels exhibited positive correlation with leukocyte and neutrophil counts (p < 0.001, r = 0.781, r = 0.638, r = 0.772, and r = 0.629, respectively). Supraventricular tachycardia developed in 1 (5.9%) patient, and dilated cardiomyopathy in another (5.9%). No mortality occurred in any case. Conclusion Increased PLT counts and PCT levels may be helpful in evaluating clinical severity in patients with scorpion sting envenomation. The possibility of myocarditis development in children should be remembered and cardiac enzymes should be checked, even if patients are asymptomatic and cardiac enzymes are normal on admission.

Scorpion envenomation-associated myocarditis: A systematic review

“…Among these, respiratory distress [ 26 , 28 , 34 , 36 – 38 , 40 , 43 – 48 , 51 , 59 , 63 – 71 , 73 – 92 ] and increased heart rate (tachycardia) [ 13 , 27 , 34 , 36 – 39 , 43 , 44 , 47 , 53 , 56 , 58 , 59 , 61 , 64 – 66 , 68 , 69 , 74 , 75 , 77 – 89 ] were the most common manifestations affecting 94.8% (145 from 153) and 82% (137 from 167) of the patients, respectively. In studies where the prevalence of pulmonary edema could be determined unequivocally, it was observed in 60.7% (246 from 405) of patients [ 13 , 27 , 34 , 36 – 39 , 42 – 44 , 47 , 48 , 51 , 56 , 58 , 59 , 64 – 66 , 69 , 75 ,…”

“…Ventricular tachycardia was another important finding [ 71 , 75 , 76 , 84 ]. Laboratory findings associated with myocarditis were raised levels of cardiac troponin T [ 49 , 57 , 61 , 64 , 70 , 72 , 75 , 87 ], troponin I [ 34 , 41 , 42 , 45 , 46 , 49 , 58 , 60 , 65 , 66 , 74 , 76 , 78 , 79 , 81 , 82 , 84 – 86 , 88 , 91 , 92 ], unspecified-type troponin [ 63 , 67 , 80 , 82 ], CK-MB [ 14 , 18 , 34 , 37 , 40 , 45 , 46 , 49 , 52 , 57 , 59 , 62 , 66 , 68 , 70 , 74 – 76 , <...…”

Retrospective Evaluation of Clinical and Epidemiological Characteristics of Scorpion Sting Cases Presenting to the Emergency Department in Izmir

“…Celik et al, in a study conducted in pediatric patients, have shown that the increase in the leukocyte, neutrophil, PLT and glucose levels of the patients was associated with the severity of the disease 12 . In this study, we observed that WBC, neutrophil, leukocyte and K elevations were associated with the development of serious disease.…”

Snakebites in Pediatric Patients in Kahramanmaraş: Is Pro-brain Natriuretic Peptide a Prognostic Biomarker for Snakebites?

“…PCT and PDW are associated with inflammation [25]. Çelik et al examined scorpion stings in children and showed that increased platelet and PCT values were predictive of serious clinical conditions [26]. In another study, an increased PDW and PDW to lymphocyte ratio showed a poor prognosis in snakebites [19].…”