scorpion sting
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Epidemiology
- 1 million cases worldwide annually[4]
Clinical manifestations
- local itching
- regional paresthesias
- diaphoresis
- dyspnea
- sialorrhea
- lacrimation
- muscle pain
- nausea/vomiting
- tachycardia
- hypotension
- cardiogenic shock in severe cases[4]
- involuntary motor activity, may progress to seizures
- cranial nerve dysfunction
Laboratory
- complete blood count (CBC) & chem7
- leukocytosis & hyperglycemia typical of stress reaction
- generally laboratory tests not useful
- severe reactions
- elevated serum creatine kinase
- abnormal renal function tests
- abnormal coagulation studies
- activated partial thromboplastin time (aPTT)
- increased D-dimer
Complications
- mortality is lower than that from snake envenomation
- among children, a risk of death[4]
Differential diagnosis
Management
- cool compresses
- analgesics
- Sawyer extractor (extracts venom with negative pressure)
- tetanus prophylaxis
- treat hypertension & tachycardia with beta blockers
- ICU for acute pulmonary edema & cardiogenic shock[4]
- scorpion antivenin (Anascorp)
- evidence for effectiveness not uniformly strong[4]
More general terms
Additional terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1172-74
- ↑ Boyer LV et al Antivenom for critically ill children with neurotoxicity from a scorpion sting. N Engl J Med 2009 May 14; 360:2090. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19439743
- ↑ FDA NEWS RELEASE: August 3, 2011 FDA approves the first specific treatment for scorpion stings http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm266611.htm
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Isbister GK and Saluba Bawaskar H Scorpion Envenomation N Engl J Med 2014; 371:457-463 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25075837 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1401108