Scorpion Envenomation Questions & Answers

1. Khatony A, Abdi A, Fatahpour T, Towhidi F. The epidemiology of scorpion stings in tropical areas of Kermanshah province, Iran, during 2008 and 2009. J Venom Anim Toxins Incl Trop Dis. 2015. 21:45. [QxMD MEDLINE Link].

2. Queiroz AM, Sampaio VS, Mendonça I, Fé NF, Sachett J, Ferreira LC, et al. Severity of Scorpion Stings in the Western Brazilian Amazon: A Case-Control Study. PLoS One. 2015. 10 (6):e0128819. [QxMD MEDLINE Link].

3. Chippaux JP, Goyffon M. Epidemiology of scorpionism: a global appraisal. Acta Trop. 2008 Aug. 107 (2):71-9. [QxMD MEDLINE Link].

4. van der Meijden A, Coelho P, Rasko M. Variability in venom volume, flow rate and duration in defensive stings of five scorpion species. Toxicon. 2015 Jun 15. 100:60-6. [QxMD MEDLINE Link].

5. Safford MM. Arizona Bark Scorpion. US National Park Service. Available at https://www.nps.gov/articles/bark-scorpion.htm. February 1, 2017; Accessed: October 15, 2021.

6. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, et al. 2019 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 37th Annual Report. Clin Toxicol (Phila). 2020 Dec. 58 (12):1360-1541. [QxMD MEDLINE Link]. [Full Text].

7. Jahan S, Mohammed Al Saigul A, Abdul Rahim Hamed S. Scorpion stings in Qassim, Saudi Arabia--a 5-year surveillance report. Toxicon. 2007 Aug. 50(2):302-5. [QxMD MEDLINE Link].

8. Shahbazzadeh D, Amirkhani A, Djadid ND, Bigdeli S, Akbari A, Ahari H. Epidemiological and clinical survey of scorpionism in Khuzestan province, Iran. Toxicon. 2009 Mar 15. 53(4):454-9. [QxMD MEDLINE Link].

9. Dehghankhalili M, Mobaraki H, Akbarzadeh A, Yazdani R, Nazemi A, Ghaffarpasand F, et al. Clinical and Laboratory Characteristics of Pediatric Scorpion Stings: A Report From Southern Iran. Pediatr Emerg Care. 2015 Nov 2. [QxMD MEDLINE Link].

10. Bosnak M, Ece A, Yolbas I, Bosnak V, Kaplan M, Gurkan F. Scorpion sting envenomation in children in southeast Turkey. Wilderness Environ Med. 2009 Summer. 20(2):118-24. [QxMD MEDLINE Link].

11. Ulug M, Yaman Y, Yapici F, Can-Ulug N. Scorpion envenomation in children: an analysis of 99 cases. Turk J Pediatr. 2012 Mar-Apr. 54(2):119-27. [QxMD MEDLINE Link].

12. Langley RL, Morrow WE. Deaths resulting from animal attacks in the United States. Wilderness Environ Med. 1997 Feb. 8(1):8-16. [QxMD MEDLINE Link].

13. Boyer L, Heubner K, McNally J, Buchanan P. Death from Centruroides scorpion sting allergy [abstract]. J Toxicol Clin Toxicol. 2001. 39:561-562.

14. Bawaskar HS, Bawaskar PH. Scorpion sting: update. J Assoc Physicians India. 2012 Jan. 60:46-55. [QxMD MEDLINE Link].

15. Skolnik AB, Ewald MB. Pediatric scorpion envenomation in the United States: morbidity, mortality, and therapeutic innovations. Pediatr Emerg Care. 2013 Jan. 29(1):98-103; quiz 104-5. [QxMD MEDLINE Link].

16. Bouaziz M, Bahloul M, Kallel H, Samet M, Ksibi H, Dammak H, et al. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: multivariate analysis of 951 cases. Toxicon. 2008 Dec 15. 52(8):918-26. [QxMD MEDLINE Link].

17. Prasad R, Mishra OP, Pandey N, Singh TB. Scorpion sting envenomation in children: factors affecting the outcome. Indian J Pediatr. 2011 May. 78(5):544-8. [QxMD MEDLINE Link].

18. Guerra CM, Carvalho LF, Colosimo EA, Freire HB. Analysis of variables related to fatal outcomes of scorpion envenomation in children and adolescents in the state of Minas Gerais, Brazil, from 2001 to 2005. J Pediatr (Rio J). 2008 Nov-Dec. 84(6):509-15. [QxMD MEDLINE Link].

19. Parma JA, Palladino CM. [Scorpion envenomation in Argentina]. Arch Argent Pediatr. 2010 Apr. 108(2):161-7. [QxMD MEDLINE Link].

20. Freire-Maia L, Pinto GI, Franco I. Mechanism of the cardiovascular effects produced by purified scorpion toxin in the rat. J Pharmacol Exp Ther. 1974 Jan. 188(1):207-13. [QxMD MEDLINE Link].

21. Pinto MC, Borboleta LR, Melo MB, Labarrére CR, Melo MM. Tityus fasciolatus envenomation induced cardio-respiratory alterations in rats. Toxicon. 2010 Jun 1. 55(6):1132-7. [QxMD MEDLINE Link].

22. Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, et al. Pulmonary edema following scorpion envenomation: mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol. 2013 Jan 10. 162(2):86-91. [QxMD MEDLINE Link].

23. Bawaskar HS. Diagnostic cardiac premonitory signs and symptoms of red scorpion sting. Lancet. 1982 Mar 6. 1(8271):552-4. [QxMD MEDLINE Link].

24. Kaplanoglu M, Helvaci MR. Scorpion stings in pregnant women: an analysis of 11 cases and review of literature. Clin Exp Obstet Gynecol. 2015. 42 (2):228-30. [QxMD MEDLINE Link].

25. Tan HH, Mong R. Scorpion stings presenting to an emergency department in Singapore with special reference to Isometrus maculatus. Wilderness Environ Med. 2013 Mar. 24(1):42-7. [QxMD MEDLINE Link].

26. Abroug F, Souheil E, Ouanes I, Dachraoui F, Fekih-Hassen M, Ouanes Besbes L. Scorpion-related cardiomyopathy: Clinical characteristics, pathophysiology, and treatment. Clin Toxicol (Phila). 2015 Jul. 53 (6):511-8. [QxMD MEDLINE Link].

27. Sundararaman T, Olithselvan M, Sethuraman KR, Narayan KA. Scorpion envenomation as a risk factor for development of dilated cardiomyopathy. J Assoc Physicians India. 1999 Nov. 47(11):1047-50. [QxMD MEDLINE Link].

28. Bhoite RR, Bhoite GR, Bagdure DN, Bawaskar HS. Anaphylaxis to scorpion antivenin and its management following envenomation by Indian red scorpion, Mesobuthus tamulus. Indian J Crit Care Med. 2015 Sep. 19 (9):547-9. [QxMD MEDLINE Link].

29. Hammoudi-Triki D, Ferquel E, Robbe-Vincent A, Bon C, Choumet V, Laraba-Djebari F. Epidemiological data, clinical admission gradation and biological quantification by ELISA of scorpion envenomations in Algeria: effect of immunotherapy. Trans R Soc Trop Med Hyg. 2004 Apr. 98 (4):240-50. [QxMD MEDLINE Link].

30. Figueiredo AB, Cupo P, Pintya AO, Caligaris F, Marin-Neto JA, Hering SE. [Assessment of myocardial perfusion and function in victims of scorpion envenomation using gated-SPECT]. Arq Bras Cardiol. 2010 Apr. 94(4):444-51. [QxMD MEDLINE Link].

31. Nouira S, Boukef R, Nciri N, Haguiga H, Elatrous S, Besbes L, et al. A clinical score predicting the need for hospitalization in scorpion envenomation. Am J Emerg Med. 2007 May. 25 (4):414-9. [QxMD MEDLINE Link].

32. Balit CR, Harvey MS, Waldock JM, Isbister GK. Prospective study of centipede bites in Australia. J Toxicol Clin Toxicol. 2004. 42 (1):41-8. [QxMD MEDLINE Link].

33. Chaou CH, Chen CK, Chen JC, Chiu TF, Lin CC. Comparisons of ice packs, hot water immersion, and analgesia injection for the treatment of centipede envenomations in Taiwan. Clin Toxicol (Phila). 2009 Aug. 47 (7):659-62. [QxMD MEDLINE Link].

34. Aksel G, Güler S, Doğan NÖ, Çorbacioğlu ŞK. A randomized trial comparing intravenous paracetamol, topical lidocaine, and ice application for treatment of pain associated with scorpion stings. Hum Exp Toxicol. 2015 Jun. 34 (6):662-7. [QxMD MEDLINE Link].

35. Chippaux JP. Emerging options for the management of scorpion stings. Drug Des Devel Ther. 2012. 6:165-73. [QxMD MEDLINE Link].

36. Boyer LV, Theodorou AA, Berg RA, et al. Antivenom for critically ill children with neurotoxicity from scorpion stings. N Engl J Med. 2009 May 14. 360(20):2090-8. [QxMD MEDLINE Link]. [Full Text].

37. Natu VS, Kamerkar SB, Geeta K, Vidya K, Natu V, Sane S, et al. Efficacy of anti-scorpion venom serum over prazosin in the management of severe scorpion envenomation. J Postgrad Med. 2010 Oct-Dec. 56(4):275-80. [QxMD MEDLINE Link].

38. Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: randomised open label clinical trial. BMJ. 2011 Jan 5. 342:c7136. [QxMD MEDLINE Link]. [Full Text].

39. Kumar CM, Prasad SV. Echocardiologic evaluation and follow-up of cardiovascular complications in children with scorpion sting in coastal South India. Indian J Crit Care Med. 2015 Jan. 19 (1):42-6. [QxMD MEDLINE Link].

40. Kumar PM, Krishnamurthy S, Srinivasaraghavan R, Mahadevan S, Harichandrakumar KT. Predictors of Myocardial Dysfunction in Children with Indian Red Scorpion (Mesobuthus tamulus) Sting Envenomation. Indian Pediatr. 2015 Apr. 52 (4):297-301. [QxMD MEDLINE Link].

41. Gupta BD, Parakh M, Purohit A. Management of scorpion sting: prazosin or dobutamine. J Trop Pediatr. 2010 Apr. 56(2):115-8. [QxMD MEDLINE Link].

42. Patil SN. A retrospective analysis of a rural set up experience with special reference to dobutamine in prazosin-resistant scorpion sting cases. J Assoc Physicians India. 2009 Apr. 57:301-4. [QxMD MEDLINE Link].

43. Centruroides (Scorpion) Immune F(ab’)2 (Equine). Prescribing information. Accessed October 15, 2021. [Full Text].

David Cheng, MD Associate Professor of Emergency Medicine, Education Director, Associate Emergency Medicine Residency Director, Case Medical Center

David Cheng, MD is a member of the following medical societies: American College of Emergency Physicians, International Society for Mountain Medicine, Council of Residency Directors in Emergency Medicine, American Heart Association, National Association of EMS Physicians, Society for Academic Emergency Medicine, Society of Critical Care Medicine, Wilderness Medical Society

Disclosure: Nothing to disclose.

Judith A Dattaro, MD, FACEP Assistant Professor of Emergency Medicine in Surgery, Cornell University Medical College; Consulting Staff, Department of Emergency Medicine, Weill-Cornell University Medical Center, New York Presbyterian Hospital

Judith A Dattaro, MD, FACEP is a member of the following medical societies: American Association of Women Emergency Physicians, American College of Emergency Physicians, American Medical Association, Chicago Medical Society, Illinois State Medical Society, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Ramy Yakobi, MD, MBA Medical Director, Department of Emergency Medicine, Beth Israel Medical Center

Ramy Yakobi, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Sean P Bush, MD, FACEP Professor of Emergency Medicine, The Brody School of Medicine at East Carolina University

Sean P Bush, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, International Society on Toxicology, Society for Academic Emergency Medicine, Wilderness Medical Society

Disclosure: Nothing to disclose.

Charles J Gerardo, MD, FACEP Associate Professor, Department of Surgery, Division of Emergency Medicine, Duke University School of Medicine; Vice Chief of Program Development, Division of Emergency Medicine, Duke University Medical Center

Charles J Gerardo, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, Council of Residency Directors in Emergency Medicine, National Hispanic Medical Association

Disclosure: Received research grant from: BTG International Inc.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Lisa Kirkland, MD, FACP, FCCM, MSHA Assistant Professor, Department of Internal Medicine, Division of Hospital Medicine, Mayo Clinic; Chair, Department of Critical Care, ANW Intensivists, Abbott Northwestern Hospital

Lisa Kirkland, MD, FACP, FCCM, MSHA is a member of the following medical societies: American College of Physicians, Society of Critical Care Medicine, Society of Hospital Medicine

Disclosure: Nothing to disclose.

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