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Scorpion stings are a public health problem in Morocco, especially among children, who experience the most severe cases. Epidemiological and clinical findings on scorpion stings in Fez, Morocco, were evaluated in this investigation. Of 163 cases that required medical attention, 62.6% were male children. The mean age of patients was 4.8 ± 3.4 years....
Contexts in source publication
Context 1
... 32.5% of the victims arrived at the hospital more than four hours after their accidents. Table 2 shows some features of the studied scorpion stings, which most commonly affected extremities (86.5%). When the animal color was seen, the yellow scorpion was easily identified by the patients (41.7%). ...
Context 2
... reason underlying such symptom severity of envenomated children could be related to their smaller body mass and decreased physiological reserves compared to adults, making them predisposed to develop the most common systemic symptoms. In this case, the predominant signs were vomiting (73%), sweating (73%), tachycardia (26.4%), tachypnea (30.7%), priapism (51%), shivering (32.2%) and fever (28.8%) ( Table 2). These symptoms indicate an adrenergic autonomic disturbance that specifically involves the sympathetic system and a cholinergic disorder that hinders the parasympathetic system. ...
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Citations
... Abroug's classification for grading Signs and Symptoms of scorpion sting cases [9,10] Grade I: Pain and/or paresthesia at the scorpion sting site, tingling, numbness, and minor swelling in the skin area encompassing the sting (local symptoms); Grade II: Fever, chills, tremor, excessive sweating, nausea, vomiting, diarrhea, hypertension, and priapism (systemic symptoms ± local symptoms); Grade III: Cardiovascular, respiratory, and/or neurologic distresses (complications). ...
Scorpions represent very dangerous arachnids of the order Scorpiones (Phylum: Arthropoda, Kingdom: Animalia). Scorpion envenomation is a life-threatening health issue in tropical and subtropical regions. The Egyptian map can reveal many of these night-crawling creatures in different parts of the country. Scorpion venom has special characteristics that must be more studied to get the mysterious treasure inside. Also, the management of an envenomated person must have a widespread upto-date protocol around the world.
... Localized pain, hyperemia, vomiting, sweating, restlessness, tachycardia, and tachypnea have been reported in children. Research reports showed that symptoms of scorpion sting in a child includes persistent crying, uncontrollable limb jumping, and facial muscle twitching that gives it a scary appearance (73)(74)(75)(76). ...
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.
... Localized pain, hyperemia, vomiting, sweating, restlessness, tachycardia, and tachypnea have been reported in children. Research reports showed that symptoms of scorpion sting in a child includes persistent crying, uncontrollable limb jumping, and facial muscle twitching that gives it a scary appearance (73)(74)(75)(76). ...
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.
... Furthermore, the arms and legs were the most affected areas of the body (86.1%). These results are similar to previous studies in the literature [16][17][18] Depending on the effect of toxins, abnormal hematological values (leukocytosis, thrombocytopenia), renal (increased urea and creatinine), liver [increased ALT and aspartate aminotransferase (AST)], cardiac (tachycardia, bradycardia, ST-T changes), and pulmonary involvement can be seen [3,6]. In our study, when the control blood values of the patients were compared during admission and discharge, glucose, urea, creatine, total protein, ALT, Na (sodium), K (potassium), WBC, RBC, hemoglobin, hematocrit, and neutrophil values were found to be significantly higher. ...
Introduction
Scorpion sting in children is still a serious health problem today. Children are at greater risk of developing severe cardiac, respiratory, and neurological complications because of their low body weight. In this study, we retrospectively evaluated the demographical changes, complaints, clinical findings, and laboratory results of scorpion sting cases admitted to the pediatric emergency department.
Materials and Methods
The records of 72 patients who were followed up with the diagnosis of scorpion sting in the Dicle University Pediatric Emergency Department between 2013 and 2017 were retrospectively analyzed.
Results
The patients included in the study were between one and 15 years (7.64±4.04 years) and 43.1% were male, and 56.9% were female. While 65.3% of the cases lived in rural areas, 34.7% lived in the city center. The most common stung areas in the cases were the lower extremity (51.4%) and the upper extremity (34.7%). The most common complaints in the patients were 70.8% pain, 58.3% edema, 41.7% cold extremities, 23.6% sweating, 22.2% vomiting, and 12.5% excessive salivation. Of the cases, 71.4% had mild, 25.7% had moderate, and 2.9% had severe stages. Of the patients, 91.6% were given antivenom, 75.7% were given antihistamines, 74.3% were given steroids, 65.7% were given antibiotics, 64.3% were given analgesics, 44.3% were given tetanus vaccine, 2.8% were given erythrocyte suspension and 1.4% were given platelet suspension. In addition, 11.4% of the cases were given prazosin treatment. While 32.9% of the cases required intensive care, two patients died. A statistically significant difference was found between the glucose, urea, creatine, total protein, sodium, potassium, alanine aminotransferase, white blood cell count, red blood cell count, hemoglobin, hematocrit, neutrophil count values of the patients at admission and discharge.
Conclusion
Scorpion sting cases are still a significant health problem. The severe clinical course is more common in children. The management of patients with severe clinical forms is based on early recognition of the sting, antivenom serum administration, and cardiorespiratory and systemic support.
... Our result is in agreement with that of other studies conducted in Ramhormoz and Kashan. In Iran, Turkey, and Morocco, there have been reports on a high number of scorpion sting cases during the hot season of the year (Talebian and Doroudgar 2006;Abourazzak et al. 2009;Uluğ et al. 2012;Karami et al. 2013). Scorpions are active in warm seasons, which correlates with the increased number of scorpion stings cases during summer. ...
Shahi M, Jaberhashemi SA, Hanafi-Bojd AA, Akbari M, Rafinejad J. 2020. Faunistic study on scorpions and their health impact in Bashagard County, Hormozgan Province, Southern Iran. Nusantara Bioscience 13: 85-90. Scorpion sting is a major public health problem in tropical and subtropical countries, endangering thousands of lives annually. About 2300 scorpion sting cases including several deaths are reported from Hormozgan Province annually. This study aimed to determine the fauna of scorpions and epidemiological aspects of scorpion sting in one of the high-risk areas in this province. Scorpions were collected by diurnal searching and night catch using UV light during 2015-2016. Clinical and demographic data of scorpion sting were obtained from Hormozgan Health Center using the checklist of the Center for Disease Control (CDC) archive during the study period. Data analysis was performed using SPSS 21 software. A total of 382 scorpions comprising of 9 species belonging to Buthidae (76%) and Hemiscorpiidae (24%) families were collected and identified as Mesobuthus phillipsi, Androctonus crassicauda, Hottentotta sistanensis, Compsobuthus persicus, Hemiscorpius acanthocercus, Orthochirus farzanpayi, H. acanthocercus, and Odontobuthos sp. The most abundant species in the study area was M. phillipsi. During 2015-2016, a total of 1221 scorpion sting cases including four deaths were recorded in Bashagard County, while most of the cases occurring during summer. The climate of the eastern regions of Hormozgan Province provides a suitable habitat for one of the deadliest genera of scorpions, i.e. Hemiscorpius. This genus is the main cause of death due to scorpion sting in these regions. It is thus necessary to design appropriate programs for the prevention and treatment of scorpion sting, including health education programs for both community members and healthcare personnel.
... Many other researchers have confirmed that the high ratio of cases occurs in the upper and lower limbs. Scorpion stings at the other parts of the body such as trunk, chest head and neck mostly occur during relaxation or sleeping, also a group of scientist in Morocco has obtained the same result [22]. ...
... The number of worldwide scorpion stings is estimated as 1.2 million annually, with 3,250 (0.27%) resulting in death [2,11]. However, there are studies reporting 100.000 scorpionism cases annually with 800 resulting in death globally [14][15][16]. In the literature screening, we could not reached to healthy data about the incidence in Turkey. ...
The aim of this study was to compare the use of antivenom, and admission to ICU, scorpinism between adult and pediatric patients. This study included 99 patients who were admitted to the emergency department with scorpion sting within 1 year. Patients demographics including age and gender, and clinical findings such as ionized Ca values, body region of sting contact and complications were recorded from the patient files and hospital records. In addition, regarding management of patients with scorpionism the use of antivenoms, admission to intensive care unit and complications developed by the patients were also recorded. Patients were divided into two groups according to age as the pediatric group including patients aged ≤ 18 years (Group 1) old and the adult group consisting of patients aged> 18 years old (Group 2). Antivenom administration was performed in 12 patients (12.2%). Antivenom was administered in 38% (n=8) of the patients in Group 1 and 5.13% (n=4) of the patients in Group 2. The mean age of patients who received antivenom was statistically significantly lower than the patients who did not receive antivenom (p [Med-Science 2020; 9(1.000): 109-13]
... Most cases of scorpionism are characterized by the development of local symptoms after venom inoculation in the skin (Abourazzak et . Clinical manifestations associated with different species of scorpion include intense pain, with an incidence of approximately 81%, followed by hyperemia, scarification, and itching (Abourazzak et al., 2009). Interestingly, previous exposure to Centruroides vittatus scorpion venom has been reported to predispose individuals to increased dermal manifestations 48 h after clinical injection of the venom, diluted at 1:100,000, whereas naïve subjects have not been reported to show local symptoms as severe as those observed in pre-exposed subjects (Demain and Goetz, 1995). ...
... For example, hyaluronidase and metalloproteinases act as spreading factors by degrading the extracellular matrix of the skin and promote hyperemia and intense pain (Pucca et al., 2015a(Pucca et al., , 2015b(Pucca et al., , 2015c. Moreover, the presence of vasoactive amines is associated with increased blood flow to the bite region, thereby enhancing redness and edema (Abourazzak et al., 2009;Demain and Goetz, 1995;Pucca et al., 2015aPucca et al., , 2015bPucca et al., , 2015cRahmani and Jalali, 2012). Actually, if accidents with scorpions were limited to the local effects, such as pain and some discomfort after a few hours of the sting, the impact on public health would be different. ...
Scorpion envenomation results in a wide range of clinical manifestations that are mostly attributed to the activation of the autonomic nervous system by venom toxins. In fact, sympathetic and parasympathetic disturbances play important roles during poisoning. However, scorpion venom also induces a complex hyperinflammatory state that occurs parallel to systemic inflammatory response syndrome and acute sepsis. After a scorpion sting, innate immune cells are exposed to the venom molecules, which bind to pattern recognition receptors and activate pro-inflammatory pathways that contribute toward the promotion of severe symptoms, such as pulmonary edema, and eventually lead to death. In this review, we highlight studies that pointed out inflammation as a major pathological facet of scorpion envenomation, so as to provide novel targets to improve therapeutics for scorpionism.
... Abroug's classification for grading Signs and Symptoms of scorpion sting cases [7,8] Grade I: Pain and/or paresthesia at the scorpion sting site, tingling, numbness and minor swelling in the skin area encompassing the sting (local symptoms) ...
... Concerning time after sting (TAS) which considered an important risk factor in determine severity and mortality in scorpion envenomation cases; the time elapsed between the sting and hospital admission was between 15 min and 120 min with a mean of 31 ± 75 min. Moreover more than half of the cases attended the emergency unit within half an hour after sting, this can be explained by occurrence of sever agonizing pain in the majority of cases (70.6%)immediately after sting force them to seek medical consultation rapidly and hospital admission [8], while 47.3% ...
... have a delayed access to the medical care, this delay in seeking this medical care may be attributed to barriers in access to health facilities due to difficulty in transportation and scanty of heath care facilities in these areas. TAS appears to be critical because scorpion venom propagates very rapidly through the victim's body, as proven in clinical and experimental reports [8]. Death rate was 75% when TAS was more than two hours, this due to delayed medical assistance constituted a negative impact on envenomation prognosis; hence, patients that arrived at the hospital more than two hours after sting have a greater risk of unfavorable evolution [15]. ...
Background and aim
Scorpion envenomation is a common acute life threatening health problem in developing countries as Egypt. Scorpion venom is a complex structure composed of neurotoxic proteins, salts, acidic proteins, and organic compounds, thereby having of neurologic, cardiovascular, hematologic, and renal side effects, in addition to local effects such as redness, pain, burning, and swelling.
Aims
The study consisted of two parts to describe demographic characteristics, toxicological manifestations of scorpion sting cases in Luxor, Egypt and morphological characterization of the commonest scorpion species in the studied community for easy rapid identification of scorpion species by doctors from the patient history to provide better choices of management
Materials & methods
First part of the study include all cases of scorpion envenomation attending General Hospital of Esna, Luxor, Egypt during the period of scorpion activity 2017, demographic data was collected then cases were assessed for clinical manifestations, ECG, complications and deaths related to scorpion species. Second part: scorpions were collected from areas around patient housing for morphological description of their sense organs and venom apparatus by Scanning Electron Microscopy.
Results
A total of 110 cases of scorpion stings were reviewed, males 81 (72.9%) and females 30 (27.1%), with a mean age of 31.9 ± 17.9 years. Localized pain was the most frequent presenting complaint (89 80.2%), vomiting was the commonest clinical symptom (90.9%). All scorpion stings were due to the most endemic species in North Africa, Leiurusquinquestriatus & Androctonuscrassicauda. Death rate among cases was (5.5%) all were Abroug’s Grade III. Cardiac dysrhythmia and subsequent pulmonary edema were the commonest cause of death. Clinical manifestations were more sever in Leiurus quinquestriatus stings while death rate was more in Androctonus crassicauda stings. The morphological characterization of the sense organs (eyes, pedipalps, pectines& sensory setae) and venom apparatus of the scorpions L. quinquestriatus & A. crassicauda were described by Scanning Electron Microscopy.
Conclusion
Scorpion sting is an acute heath threating in Southern Egypt, Leiurus quinquestriatus & Androctonus crassicauda are most endemic scorpion species in Southern Egypt. More attention for scorpion envenomation in such subtropical hyper desert localities is required to eradicate toxic scorpion species and prevent possible causes of deaths.
... The severity of these symptoms is mainly correlated to the age of the person exposed to the venom, but it is particularly dangerous in children (Guidine et al. 2008, Bahloul et al. 2010, El Hidan et al. 2015. Currently, 25,000 scorpion stings are recorded per year in Morocco and 90% of fatal cases are patients younger than 10 years old (Abourazzak 2009). ...
Rats animal model was used to assess the severity of symptoms produced following the Intracerebroventricular injection (ICV) of incremental doses of Buthus lienhardi scorpion venom based on histopathological, biochemical, and hematological analyses. Our results show that the ICV injection of incremental doses of scorpion venom induced a dose-dependent effects resulting in death when high doses were administrated (5.4 and 8.1 µg/kg). Moreover, ICV administration of lower doses of B. lienhardi (0.27 and 2.7 µg/kg) produced marked myofibrillar degeneration, while lungs showed intra-alveolar hemorrhage. Concomitantly, there was a significant rise in the serum levels of AST, ALT, CPK, LDH, urea, and creatinine.
