09 August, 2012

An updated review on scorpion envenomation

Bawaskar & Bawaskar have recently published an updated review on scorpion venom, envenomation and treatment. The paper has a special emphasis on Indian scorpionism, but observations and studies from other parts of the world is also presented.

Please note that the scorpion taxonomy in the paper is not up to date for all taxa mentioned (e.g. Mesobuthus tamulus is used for Hottentotta tamulus and Palamneus gravimanus is used for Heterometrus gravimanus).

Scorpion envenomation is an important public health hazard in tropical and sub-tropical regions. Envenomation by scorpions can result in a wide range of clinical effects, including, cardiotoxicity, neurotoxicity and respiratory dysfunction. Out of 1500 scorpion species known to exist, about 30 are of medical importance. Although a variety of different scorpion species exist, majority of them produce similar cardiovascular effects. Scientists and clinicians have studied patho physiology of scorpion envenomation by critical observations of clinical, neurotransmitters studies, radioisotope studies, echocardiography and haemodynamic patterns. Regimen including scorpion antivenom, vasodilators, intensive care management have been tried to alleviate the systemic effects of envenoming. In spite of advances in patho-physiology and therapy the mortality remains high in rural areas due to lack of access to medical facilities, moreover the medical attendee from developing tropical countries may not be aware of the advances in the treatment of scorpion sting. Since the advent of scorpion Antivenom, vasodilators, dobutamine and intensive care facilities, the fatality due to severe scorpion sting has been significantly reduced in areas where these treatment modalities are used.

Bawaskar HS, Bawaskar PH. Scorpion sting: update. J Assoc Physicians India. 2012;60:46-55. [Free full text]

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