28 June, 2013

Scorpionism in French Guiana

Benmesbah Mohamed and co-workers have recently published a epidemiological study on scorpion envenomations in French Guiana.

Scorpion envenomations are an increasing problem in French Guiana, but so far there have been no deaths recorded. Only a few serious cases are presented in this paper, all involving young children. Involving scorpions are usually not identified (color and claw size only), but serious cases probably have Tityus species involved (e.g. Tityus obscurus is a common black species in French Guyana).

The authors conclude that scorpion envenomations in French Guiana pose no major medical problem, but warn that cases involving children may be more serious and should be monitored carefully.

Scorpion envenomation is a poorly explored problem in French Guiana. The aim of our study was to describe the epidemiological and clinical features of scorpion stings.
Methods: Our study is retrospective. It was conducted in the emergency department (ED) of Cayenne General Hospital study, over an 8-year period (2003–2010).
Results: During the study period, 253 patients presented to the emergency department with a history of a scorpion stings. The mean incidence was 32 8 cases per year. The peak of incidence was observed in April and May which are the rainiest months in the year. In most cases, the envenomation occurred between 6:00 and 11:00 am. The site of the sting was on the extremities (hand or foot) in 81% of cases. The scorpion was identified or brought to the hospital in 113 cases. It was described as a slim pincers scorpion in 97 cases. The mean time elapsed between the scorpion sting and admission was 4 5 h. The main clinical symptoms at admission to the ED were local signs in 178 cases (70.4%), digestive disorders in 13 cases, neurologic manifestations in 18 cases, and respiratory manifestations in 7cases. Adrenergic syndrome was found in 117 cases (46.2%), and cholinergic syndrome in 5 cases (2%). Hypertension was found in 80 patients, 14 of them had already a history of chronic hypertension. Overall, a total of 118 patients (46.6%) had Class I envenoming, 131 patients (51.8%) had Class II envenoming, and 4 patients (1.6%) experienced Class III envenoming. The evolutionwas favorable in all cases and no death was recorded. However, 42 patients (18.2%) were hospitalized in a medical unit and 4 patients were hospitalized in ICU without needing mechanical ventilation, inotropes or vasoactive drugs.
Conclusion: Scorpion envenomation is an increasing accident in French Guiana. Symptoms vary from mild to severe and can require ICU admission. Practitioners have to be made aware of severe cases found mainly in children.

Mohamed B, Guegueniat P, Mayence C, Egmann G, Narcisse E, Gonon S, et al. Epidemiological and clinical study on scorpionism in French Guiana. Toxicon. 2013 Jun 19; Article in Press. [Subscription required for fulltext]

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