Scorpion Envenomation

Isbister, Geoffrey K.; Bawaskar, Himmatrao Saluba

doi:10.1056/nejmra1401108

Cited by 224 publications

(286 citation statements)

References 24 publications

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“…It was shown that the sting of A. bicolor may cause pain, hyperemia, vomiting, swelling, restlessness and hypotension [73]. It is likely that the high abundance of AbNaTxs and AbKTxs in the venom glands of A. bicolor could play a major role in human envenomation caused by the scorpion according to the previous investigations on other poisonous scorpions [74]. In addition, AbBpps could cause pulmonary edema, and Androcin18-1 and Androcin18-3 may cause cell damages or lysis.…”

Section: Discussionmentioning

confidence: 99%

Unique diversity of the venom peptides from the scorpion Androctonus bicolor revealed by transcriptomic and proteomic analysis

Zhang

Shi

Zeng

et al. 2015

Journal of Proteomics

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Section: Discussionmentioning

confidence: 99%

Unique diversity of the venom peptides from the scorpion Androctonus bicolor revealed by transcriptomic and proteomic analysis

Zhang

Shi

Zeng

et al. 2015

Journal of Proteomics

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“…However, only 30 are considered dangerous to man, with 29 of them belonging to the family Buthidae. Only 11 account for serious/fatal envenoming, including scorpions of the genus Androctonus and Buthus in North Africa, Leiurus in the Middle East, Tityus in South America, Centruroides in North and Central America, Mesobuthus in Asia (especially in India), and Parabuthus in South Africa (1) (2) . In Brazil, medically important scorpions belong to Tityus genus; the major envenoming-related species are T. serrulatus and T. bahiensis in the Southeast, T. stigmurus in the Northeast, and T. obscurus (paraensis) in the North (Figure 1) (5) .…”

Section: Introductionmentioning

confidence: 99%

Clinical update on scorpion envenoming

Cupo

2015

Rev. Soc. Bras. Med. Trop.

110

126

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Scorpion stings are currently the leading cause of venom-related injury to humans in Brazil and are a signifi cant public health problem globally. Only scorpions of the Tityus genus are of medical importance in Brazil, and Tityus serrulatus is responsible for the most serious envenomations and deaths. The toxic effects of scorpion envenomation are due to a massive release of sympathetic and parasympathetic neurotransmitters; the severity is related to cardiac and hemodynamic changes, with cardiogenic shock and pulmonary edema contributing to the main causes of death. The pathophysiology of cardiac involvement has been discussed for decades and has been attributed to adrenergic discharge and a possible toxic effect of venom on the myocardium, while acute pulmonary edema may have a cardiogenic and/or non-cardiogenic origin. Currently, the clinical data point to catecholamine excess as the cause for reversible scorpion cardiomyopathy. These data include electrocardiographic changes, profi ling of cardiac enzymes and troponin I, echocardiographic data with global or regional left ventricle dysfunction, and myocardial perfusion alterations compatible with spasm in the coronary microcirculation. Furthermore, recent data on cardiac magnetic resonance imaging fi ndings, which are similar to those observed for stress-induced cardiomyopathy, have also been linked to catecholamine excess. The effi ciency of antivenom serum treatment is controversial in the literature. Our experience in Brazil is that the management of patients with systemic manifestations of scorpion stings is based on three approaches, all of which are extremely important. These include symptomatic treatment, antivenom serum, and cardiorespiratory support.

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“…This stimulates both sympathetic and parasympathetic autonomic centers and releases epinephrine, norepinephrine, neuropeptide Y and endothelin-1. 4 The parasympathetic effects of the venom are generally less severe than the sympathetic responses. Signs of parasympathetic involvement appear soon after the sting happens, and the patient may have bronchospasm, bronchorrhea, salivation, miosis, diarrhea, bradycardia, and diaphoresis.…”

Section: Discussionmentioning

confidence: 99%

“…Signs of parasympathetic involvement appear soon after the sting happens, and the patient may have bronchospasm, bronchorrhea, salivation, miosis, diarrhea, bradycardia, and diaphoresis. 4 The sympathetic effects are often much more severe because of the additional effects of circulating catecholamines. Patients may develop myocardial injury, pulmonary edema, and cardiogenic shock.…”

Section: Discussionmentioning

confidence: 99%

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

Castillo¹,

Attaluri²

2018

The Chronicles

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Keywords: scorpion, envenomation, acute respiratory failure, anaphylaxis did not relieve her symptoms. She had labored breathing with retractions and was making grunting noises. She also had a swollen tongue and throat, stridor, and diminished breath sounds; she had no skin rash. Vital signs included blood pressure 160/93 mmHg, heart rate 95 beats per minute, and respiratory rate 22 breaths per minute. Initial laboratory testing showed WBC 10.2 k/µL with 2.1% eosinophils, hemoglobin 13.4 gm/dL, and platelet count 284 k/µL. A complete chemistry panel results included sodium 140 mEq/L, potassium 3.6 mEq/L, chloride 104 mEq/L, BUN 15 mg/dL, and creatinine 1.0 mg/dl. Arterial blood gases included a pH 7.24, PaCO 2 62 mmHg, and a PaO 2 79 mmHg on a FiO 2 100%. Oral intubation failed, and an emergency cricothyrotomy was done. She did not receive corticosteroids or scorpion antivenom.The patient was transferred to University Medical Center in Lubbock, TX, using mechanical ventilation during transport. Her husband reported that she had allergies to aspirin, penicillins, doxycycline, nabumetone, and bee stings. Vital signs included blood pressure 89/63 mmHg, heart rate 90 beats per minute, and respiratory rate 16 breaths per minute. Her oxygen saturation was 96% on a FiO 2 of 45%. Initial

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Scorpion Envenomation

Cited by 224 publications

References 24 publications

Unique diversity of the venom peptides from the scorpion Androctonus bicolor revealed by transcriptomic and proteomic analysis

Unique diversity of the venom peptides from the scorpion Androctonus bicolor revealed by transcriptomic and proteomic analysis

Clinical update on scorpion envenoming

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

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