Consequences of scorpion stings in adults in Israel

Meir Antopolsky and co-workers have studied symptoms of scorpion stings in 113 adult patients in Israel. 25% of the patients were stung by black scorpions (Androctonus crassicauda or one of the black species which are less venomous) and 70% were stung by yellow scorpions (probably Leiurus quinquestriatus hebraeus according to the authors).

Interestingly, none of the patient developed serious, systemic symptoms (even though some potential dangerous species probably were involved). These results are consistent with similar studies from other parts of the Middle East. It is important to stress that scorpion sting in children or infants can be dangerous because of the larger amount of venom compared to body weight.

There are two limitations with this study: The patients included were from one hospital only (and from a limited geographic region). In addition, a precise identification of involved scorpions was not conducted. It is therefor possible that dangerous species like Leiurus and Androctonus were involved in a lesser degree than assumed by the authors.

Abstract:
Objective: To question the existing practice to observe the victims of scorpion sting in the emergency department at least for 6 h.Methods: Prospective study of all adult patients presenting to emergency department after scorpion sting during 3 years, and review of existing literature from Middle East countries.Conclusion: Serious toxicity after scorpion sting in Israel and some of neighboring countries is rare, and always presents within 1 h from the sting. Thus, prolonged observation can be reserved for a high-risk population and patients with serious toxicity on admission.

Reference:
Antopolsky M, Salameh S, Stalnikowicz R. Need for emergency department observation after scorpion sting: prospective study and review of the literature in the Middle East. Eur J Emerg Med. 2009 Aug;16 (4):206-8. [Susbcription required for fulltext]