Predictive Value of Glycemia and Free Fatty Acid Levels upon Admission of Children with Scorpionism in Egypt

Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.

Climate Change, Scorpion Ecology, and Envenomation

Every year, more than 1 million cases of scorpion envenomation are reported worldwide. Scorpions are thermophilic organisms. They are sensitive to weather and climate conditions, in such a way the ongoing trends of increasing temperature and more variable weather could lead to scorpionism spreading. There has been considerable debate as to whether global envenomation will be impacted by climate change which has focused on snake and spider envenomation risk. This debate didn't give enough interest to scorpion stings and its burden risks, in spite their widespread potential effects in many regions. Here, the authors review how climate and climate change may impact scorpion activity as well as scorpion envenomation. They contrast ecological and behavioral characteristics of these arthropods, and how weather, climate, climate change, and socioeconomic factors may have very different impacts on the spatiotemporal occurrence and abundance of scorpions, and the resulting scorpion envenomation.

Acute Myocarditis Due to Scorpion Sting in a 9-year-old Girl

A 9-year-old girl with signs and symptoms of acute toxic myocarditis and cardiogenic shock with elevated cardiac enzymes was admitted to the Critical Care Unit (CCU) of our hospital with an ejection fraction of 25%. The patient was managed with supportive care and the administration of polyvalent antivenom and inotropes, and after 8 days, she was discharged without any complication with normal ejection fraction. Toxic myocarditis can be a result of scorpion envenomation. After two months of follow-up, the patient recovered completely and medications were discontinued.

A Cardiogenic Shock Following A Scorpion Envenomation : A Case Report

Scorpion envenomation constitues a common and serious clinical situation in several regions in Morocco that worsens the vital prognosis of the patient. One of the most serious forms is cardiogenic shock which is associated with high mortality.

Socio-demographic, clinical, laboratory profile and outcome in children with scorpion envenomation

Background: Aim was to study clinical, socio- demographic and laboratory profile and outcome in children with scorpion envenomation up to 12 years of age. This study conducted to provide better insights in to the socio-demographic, clinical, laboratory profile of scorpion envenomation in rural health setting in India.Methods: This was a hospital based, prospective observational study done in children up to 12 years of age admitted in a tertiary care centre between March 2018 to April 2020 with history of scorpion envenomation, presence of sting mark or scorpion seen in vicinity of child by parents or near family members. Unknown bites or stings and cases were the clinical manifestations are not compatible with scorpion sting were excluded.Results: During the study period, 28 children were admitted for scorpion sting. Maximum number of cases were noted in the age group of 3-6 years and there is equal distribution of cases among males and females .Majority of cases from rural areas, 46.42% of the cases had black scorpion sting, most of the stings occurred during evening time and spring season. The most common sting sites were the distal part of the extremities. Pain at the sting site and local swelling were the most common presenting symptoms. The common signs noted were tachycardia. The most common ECG changes were noted in the present study was sinus tachycardia (46.42%) fallowed by ST segment changes noted in 21.4% of children. Commonest complications noted myocarditis, pulmonary edema, myocardial dysfunction, peripheral circulatory failure. One patient died due to pulmonary edema. Majority of the cases recovered without any sequale.Conclusions: Scorpion envenomation is a preventable emergency among children and closely associated with environmental condition, socioeconomic status and child activities. Supervised outdoor play, early hospitalization, close monitoring of vitals and management of complications and supportive care may reduce the mortality and morbidity.

Profile of Electrocardiographic Changes in Scorpion -Envenomation

Patients presenting with alleged scorpion envenomation is a common presentation in rural tertiary hospitals. The clinical prole of scorpion envenomation has been well established. However, data on the electrocardiographic changes in scorpion envenomation, particularly of patients presenting to a south Indian rural tertiary hospital are scant. In this cross-sectional study of 90 patients presenting to our hospital, we describe the electrocardiographic ndings of patients with scorpion envenomation. Data on correlation between severity of scorpion envenomation and ECG changes are also presented. The clinical prole of scorpion envenomation is varied, in its severity and by the type of scorpion, hence, the ECG may be a cheap and simple tool to detect warning signs early to initiate timely and appropriate management