Scorpion Sting Decreases Pulse Rate and its Possible Management: A Case Report (original) (raw)
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A Study Of ECG abnormalities associated with scorpion sting in a tertiary care centre, Kadapa
Background: Scorpion stings, though not a big problem in many developed countries, it is a major public health problem in underdeveloped and in some developing countries all over the world. In India, many people are stung by the red scorpion (Mesobuthus tamulus) with recorded fatalities in both adults and children. Scorpion sting is considered as a life threatening medical emergency of villagers in India. Numerous envenomations go unreported. Hence, true incidence is frequently unavailable. Among the eighty six scorpion species in India, Mesobuthus tamulus and Palamneus swammwe-dami are of medical importance. Aims and Objectives: To study the clinical spectrum and electrocardiographic changes in scorpion sting envenomation. Materials and Methods : 53 patients of scorpion sting envenomation who were admitted in Goverment medical college and hospital ,kadapa, were included in the study. The clinical spectrum, symptoms, signs, electrocardiogram, CK-MB were collected and analysed Result: 53 patients were included in the study out of which 30 were male and 23 were female. There was no significant difference in clinical presentation with respect to age group and gender. Hand was the commonest site of sting. Local pain was the most common symptom followed by local swelling, paaresthesias and redness. Tenderness at the sting site was the most common sign followed by tachycardia. Pulmonary edema was present in 3 patients.18 patients had grade 3 envenomation and all those 18 patients had significant ECG changes and serum CK-MB was elevated in all these 18 patients .Sinus tachycardia was the most common ECG abnormality. Conclusion: In this study eighteen out of 53 cases had ECG changes. Three of the patients presented with pulmonary edema. There was no mortality due to scorpion sting in the study period. There was significant correlation between the time delay and severity of envenomation. This indicates a need for immediate medical care following scorpion sting Following this study it is seen that patients were stung by the scorpions due to their lack of knowledge about scorpions and due to their carelessness, like putting their hands in to scorpion homes. Follow up studies are required to assess the long term complications of scorpion stings.
Clinical Features and Complications of Scorpion Sting: A Descriptive Study
Background: Scor pion sting is a common pr oblem in r ur al par ts of India. It is uncommon for patients with scor pion sting to present with life threatening complications. This study aimed to describe the clinical manifestations and complications of scorpion sting. Methods: A descr iptive study of clinical featur es and complications of patients diagnosed with scor pion sting and admitted in two hospitals attached to Jagadguru Jayadeva Murugarajendra (J.J.M) Medical College in Davangere, a state at the southern India. Results: A total of 52% of scorpion sting cases were patients between the age group of 15 to 30 years. Pain at the sting site (100%) and tachycardia (78%) were the most common presenting signs and symptoms respectively. Pulmonary oedema (24%) and myocarditis (18%) were the two most serious complications. Most of the cases (94%) recovered completely without any sequale. Mortality (4%) was secondary to severe pulmonary oedema and myocarditis. Conclusion : Cardiovascular complications were most common causes of death from scorpion sting. Early treatment may prove to be necessary for complete recovery.
Journal of Emergency Practice and Trauma
Introduction Scorpions are invertebrate animals which are part of arthropods family and have a worldwide distribution (1,2). Every year, hundreds of thousands of scorpion stings occur in the world. Iran after Mexico and Colombia has a significant prevalence of scorpion stings in the world (3,4). According to the type of climate and weather, Iran is very rich in arthropods species, especially scorpions. Iran is among the countries that has a lot of scorpions, particularly dangerous species (5,6). Although deaths from stings occur in all regions of the country, about 75% of deaths occur in Khuzestan, Sistan and Baluchestan, Kerman and Hormozgan (7). Studies conducted in Iran shows that scorpions in Iran are from 3 families of Buthidae, Hemi Scorpid and Scorpionidae (8,9). Scorpion venom is a colorless and transparent liquid containing neurotoxin, hemotoxin and cardiotoxin. Enzymes include listinaz, hyaluronidase, phospholipase, and proteinase may ease the impact of venom (10). Clinical symptoms are different due to various scorpion species and different mechanisms of toxins and may include increased irritability, restlessness, increased body temperature, increased respiratory rate, shortness of breath, increased or decreased heart rate, sweating, nausea and vomiting, swallowing disorders, difficulty in speaking, seizures, and coma. Common symptoms of scorpion stings include dilated pupils and intermittent eye movements, excessive secretion of saliva and dysphagia, and finally agitation (7,11,12). According to multiple reported cases of scorpion stings in East Azarbaijan province and especially the city of Tabriz, we decided to investigate the epidemiological status of patients with scorpion sting in Tabriz city and introduced approaches toward the prevention of the sting, timely
https://www.ijhsr.org/IJHSR\_Vol.10\_Issue.1\_Jan2020/IJHSR\_Abstract.010.html, 2020
Background: Scorpion sting in pediatric age groups is a life-threatening emergency especially in dry, hot environment of tropical and subtropical countries. ECG is one of the easily available tools and ECG changes are well established in scorpion envenomation. Aims and Objectives: To correlate electrocardiographic findings at the time of admission with the final outcome in children with scorpion sting. Material and Methods: This prospective cohort study was conducted over a period of two years. A total of 92 pediatric patients with confirmed scorpion sting of age between two months to 18 years were included. Results: Mean age of the cohorts was 6.57±3.92 years; mean duration of stay was 3.9±1.59 days. Total 7 (7.6%) children died, and 57.14% were stung by brown scorpion. The duration between sting and PICU admission, and the need of inotrope on admission were significantly correlated with poor outcome (p <0.05). Most common ECG characteristic finding was change in rate (tachycardia). Abnormal rate and rhythm, abnormal ST changes, and abnormal QRS Axis are the ECG findings that significantly correlated with poor outcome of the cohorts (p< 0.05). Conclusion: Irrespective of cause of death in scorpion sting, ECG findings including rate, rhythm, ST changes, and QRS axis were found to be associated with poor outcome in pediatric patients.
2017
Introduction Scorpions are invertebrate animals which are part of arthropods family and have a worldwide distribution (1,2). Every year, hundreds of thousands of scorpion stings occur in the world. Iran after Mexico and Colombia has a significant prevalence of scorpion stings in the world (3,4). According to the type of climate and weather, Iran is very rich in arthropods species, especially scorpions. Iran is among the countries that has a lot of scorpions, particularly dangerous species (5,6). Although deaths from stings occur in all regions of the country, about 75% of deaths occur in Khuzestan, Sistan and Baluchestan, Kerman and Hormozgan (7). Studies conducted in Iran shows that scorpions in Iran are from 3 families of Buthidae, Hemi Scorpid and Scorpionidae (8,9). Scorpion venom is a colorless and transparent liquid containing neurotoxin, hemotoxin and cardiotoxin. Enzymes include listinaz, hyaluronidase, phospholipase, and proteinase may ease the impact of venom (10). Clinica...
Scorpion Bite Induced Myocardial Ischaemia and Pulmonary Edema
Journal of Case Reports, 2020
Background: Scorpion stings are common in India. Most of them are limited to moderate to severe pain at site of bite only, but good number of patients present with life threatening complications in the form of involvement of cardiac, respiratory and nervous system. Here we are reporting a case of myocarditis and pulmonary edema following sting of scorpion. Case Report: A 25 year old male presented with scorpion bite induced myocardial ischaemia, congestive cardiac failure and pulmonary edema. The cardiovascular manifestations in scorpion bite are the result of effect of venom on the sympathetic nervous system, adrenal secretion of catecholamines and the direct toxic effect of the venom on myocardium itself. Conclusion: Severe scorpion bites can present as myocardial ischaemia, congestive cardiac failure and pulmonary edema. Aggressive management with ventilator support, diuretics, parenteral steroids, antihistaminics and ionotropic agents can result in rapid clinical resolution.
Profile of Electrocardiographic Changes in Scorpion -Envenomation
GLOBAL JOURNAL FOR RESEARCH ANALYSIS, 2021
Scorpion envenomation is an occupational hazard for farmers, farm labors, villagers, migrating population and hunters. Except for Hemiscorpius lepturus, all venomous 1 scorpion species, belong to the large family Buthidae. In India, many people are stung by the red scorpion (Mesobuthus tamulus) with fatalities in adults and children. Scorpion sting is a life threatening medical emergency of 2 villagers in India. Scorpions are generally found in dry, hot environments, although some species also occur in forest and wet savannas. All species are nocturnal, hiding during the day under stones, wood, or tree barks. The risk of scorpion sting is higher in rural areas, but some species are found in close contact with man, 3 and live around or inside human dwelling. Fatalities due to sting by Buthidae have been reported from Chennai, 4,5 Rayalaseema, Pondicherry and rural Maharashtra. The annual number of scorpion stings cases exceeds 1.23million, 1 of which over 32250 may be fatal. Symptoms vary depending on the species and geographical area. The most frequently encountered symptom is excruciating local pain. Early symptoms include vomiting, profuse sweating, piloerection, alternating bradycardia and tachycardia, abdominal colic, diarrhea, loss of sphincter control and priapism. Later severe life-threatening cardiorespiratory effects may appear such as hypertension, shock and bradyarrhythmia, ECG changes and pulmonary 6
Myocarditis with Hypotension after a Scorpion Sting
Journal of Case Reports, 2017
Background: Scorpion stings are common in India and painful but rarely life-threatening. Young children and sometimes the very old are at risk of serious complications. Case Report: A 24 year old female patient was referred with myocarditis after a scorpion sting on left point finger. The patient was treated with noradrenaline, epinephrine, and dopamine infusion. After a week of therapy, patient was discharged following recovery. Conclusion: This case report emphasizes the occurrence of myocarditis after severe scorpion sting.
Scorpion bite, a sting to the heart!
Indian Journal of Critical Care Medicine
Scorpion bites are common in India. Usually, these bites are harmless but sometimes have serious clinical sequelae, including death. We report herein a case of scorpion bite with electrocardiographic abnormalities simulating early myocardial infarction. Pulmonary edema and congestive heart failure accompanied these electrocardiographic changes as well as serum cardiac markers. The etiology of cardiovascular manifestations in severe scorpion sting is related to venom effect on sympathetic nervous system and the adrenal secretion of catecholamines as well as to the toxic effect of the venom on the myocardium itself. It is a rare case of scorpion sting presented as myocardial infarction and heart failure, successfully treated with Intensive Care Unit care, noninvasive ventilation, vasopressors, and antiischemic treatment.