07 October, 2015

First report of death due to Hemiscorpius acanthocercus envenomation in Iran

It has been well known for a long time that the non-buthid species Hemiscorpius lepturus Peters, 1861 (Hemiscorpiidae) is dangerous and have caused serious morbidity and even death. Now, Mehran Shahi and co-workers report of the death of a 15 year male after being stung by a Hemiscorpius acanthocercus Monod & Lourenço, 2005. This is the first documented case involving serious scorpionism in this species, even though it has been assumed that the species in this genus may all be dangerous.

What makes the Hemiscorpius sting so special is that there is no pain or special symptoms involved short after the sting. In the present case, the patient did not seek medical help until 12 days after the envenomation and then he had developed severe complications. Other studies also reports that deaths due to Hemiscorpius stings are connected with delayed medical care due to none or mild symptoms in the days following the sting.

Hemiscorpius occurs throughout Asia (Iran, Iraq, Oman, Pakistan, Saudi Arabia, Yemen, and the United Arab Emirates) and Africa (Eritrea, Somalia, and Egypt) and it is clear that genus may be a public health risk in some areas.

Scorpion stings are significant causes of death in the western and southern regions of Iran. To date, reports have indicated that the H. lepturus species is the main cause of mortality due to scorpion stings. One of the species that belongs to this genus is Hemiscorpius acanthocercus (H. acanthocercus). This scorpion's venom is cytotoxic, and it causes pathological changes in the blood and can cause severe damage to the kidneys. The pain of Hemiscorpius’ sting is mild and asymptomatic in the early hours. Delays in the treatment of these victims can cause hemolysis, hematuria, kidney failure, and even death. In this paper, we report the first known death due to an H. acanthocercus’ sting in Iran.

Shahi M, Rafinejad J, Az-Khosravi L, Moosavy SH. First report of death due to Hemiscorpius acanthocercus envenomation in Iran: Case report. Electronic physician. 2015 Sep;7(5):1234-8. [Open Access]

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