Scorpionism is a relevant medical condition in Brazil. It is responsible for most
accidents involving venomous animals in the country, which leads to severe
symptoms that can evolve to death. In recent years, an increase of almost 50% in
the incidence of scorpionism has been observed in the Northern Region, where the
highest severity of envenoming has been notified since the beginning of the
21
st
century. This review aims to provide an in-depth assessment
of public data and reports on symptoms and epidemiology of envenoming,
ecological aspects of scorpions, and characterization of venoms and toxins to
access the gaps that need to be filled in the knowledge of the scorpion species
of medical importance from the Brazilian Amazon. A systematic search using the
string words “Amazon” and “scorpion” was performed on 11 databases. No
restriction on date, language or status of the publication was applied. Reports
not related to the Brazilian Amazon were excluded. Therefore, 88 studies
remained. It is shown that populations of scorpions of medical importance, even
of the same species, may present significant toxic variations peculiar to some
regions in the Brazilian Amazon, and commercial scorpion antivenoms were not
able to shorten the intensity and duration of neurological manifestations in
patients stung by
T. silvestris, T. apiacas
or
T.
obscurus
. It is also highlighted that the toxins responsible for
triggering these alterations have not been elucidated yet and this is a fruitful
field for the development of more efficient antivenoms. Furthermore, the
geographic distribution of scorpions of the genus
Tityus
in the
Brazilian Amazon was revised and updated. The cumulative and detailed
information provided in this review may help physicians and scientists
interested in scorpionism in the Brazilian Amazon.