31 July, 2014

Scorpionism in Egypt

Ismail Lotfy Mohamad and co-workers have recently published a retrospective study of the outcome of scorpion sting incidents in children referred to Assiut University Children Hospital
from January to December 2012.

Of the 111 cases evaluated, more than half of the stung children had a severe clinical presentation and 19 children died mainly of pulmonary edema and cardiogenic shock.

The results of this study are quite dramatic and show that scorpions are a public health problem in parts of Egypt, especially for children. The study doesn't mention scorpions species involved, but Egypt harbors several dangerous species of Androctonus and the infamous Leiurus quinquestriatus.

Scorpion envenomation is a health problem in children in tropical and subtropical regions. The aim of this study was to evaluate demographic and clinical characteristics as well as outcomes in referred children to Assiut University Children Hospital during the year 2012 with a history of scorpion sting. The medical files of these patients were reviewed retrospectively for demographic data, time and site of biting, and clinical manifestations. Laboratory investigations of the patients were reviewed for complete blood count (CBC), liver function tests, creatinine phosphokinase (CPK), lactate dehydrogenase (LDH), arterial blood gases, and serum electrolytes. Results showed 111 children with a history of scorpion sting; 69 males and 42 females with a median age of 5 years. Out of the studied patients, 53.2 % were classified as class III of clinical severity with recorded pulmonary edema in 33.3 %, cardiogenic shock in 46.8 %, and severe neurological manifestations in 22.8 %. Twelve patients (10.8 %) were classified as class II with mild systemic manifestations, and 36 % of the patients were classified as class I with only local reaction. Outcomes of these patients were discharge without sequelae in 55.8 %, discharge with sequelae in 26.1 %, and death in 18.1 %. Conclusion: more than half of stung children had a severe clinical presentation and about one fifth died. Aggressive treatment regimens are recommended for such patients to improve the outcome.

Mohamad IL, Elsayh KI, Mohammad HA, Saad K, Zahran AM, Abdallah AM, et al. Clinical characteristics and outcome of children stung by scorpion. Eur J Pediatr. 2014 June;173(6):815-8. [Subscription required for full text]

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