New study on the Buthus species in Tunisia with the description of a new species

 

Sarra Hajri and co-workers have recently published an article looking into the genetics and morphology of the known species Buthus Leach, 1815 (Buthidae) in Tunisia. Most known species are confirmed and a new species is described from the country.

Buthus saidnouirai Hajri, Bahri & Harris, 2025 

Abstract:
The taxonomy of the scorpion genus Buthus is complex due to the considerable increase in newly reported species, their high degree of similarity, and consequently, the great difficulty in their morphological differentiation. Tunisian species are not exempt from this issue, with several references highlighting the need for taxonomic revisions. This study integrates DNA sequence data and morphological assessments to investigate the diversity present in Tunisia and to provide morphological details that facilitate species identification. The results show that most Tunisian specimens are distributed within two clades. One clade comprises four subclades corresponding to B. tunetanus Herbst, 1800, B. paris C. L. Koch, 1839, B. chambiensis Kovařík 2006 and a southern group corresponding probably to B. lourencoi Rossi, Tropea & Yağmur, 2013. The second clade represents a new species described in this study as B. saidnouirai Hajri, Bahri & Harris, sp. nov. No evidence of B. dunlopi Kovařík 2006 have been recorded in the studied samples. Distances between all five species exceed the minimum divergence thresholds for Buthus species. The greatest distance was observed between B. saidnouirai. sp. nov. and the southern group, while the smallest distance was between B. tunetanus and B. paris. Although the genetic differences revealed considerable divergence of the new group from the four remaining species, the morphological assessment did not identify the same pattern. These five species demonstrate a morphological shape gradient in which B. paris and the southern group represent the two extremes, with B. paris being the most ornamented and the latter the least. The new species presents an intermediate morphology. The geographic distributions of the five reported species are discussed in this work according to the topography and orography of the region. Additional lineages known from Algeria may also enter the western fringes of Tunisia.

Reference:
Hajri S, Bahri L, Harris DJ. New Insights on Genetic and Morphological Divergence Among a Buthus Species Complex From Tunisia With the Identification of a New Species. Ecology and evolution. 2025;15(12):e72556. [Open Access]

Thanks to Gerard for sending me this article!

Family Buthidae 

Phylogeography of Androctonus species in Tunisia in view of their medical importance

 

The genus Androcronus Ehrenberg, 1828 hosts many medical important species in Tunisia and the rest of North Africa. Information about inter- and intraspecific variation of the Androctonus species is important, especially if this has consequences for medical importance and treatment of sting cases.

A. Ben Othmen and co-workers have recently published a study on the phylogeography and a phylogenetic analysis of Androctonus species in Tunisia. The results supported the current species Androctonus aeneas C. L. Koch, 1839, Androctonus amoreuxi (Audouin, 1839) and Androctonus australis (Linnaeus, 1758), but not the existence of subspecies of A. australis. 

The authors recommend that toxicologists should not refer to "species" or forms like "A. australis Hector", but suggest that it may be wise to produce anti-venom in Tunisia by using both morphological forms of A. australis.

Abstract:
A fragment of the mitochondrial (mt) 16S ribosomal RNA gene was amplified by PCR and sequenced from individual adult scorpions of the genus Androctonus, which were sampled from central and southern Tunisia and identified using an explicit set of morphological characters. Phylogenetic analyses placed the mtDNA haplotypes in three well-supported monophyletic lineages, corresponding to the morphospecies Androctonusaeneas, Androctonusamoreuxi and Androctonusaustralis. The latter species was the most abundant and widespread, and it was characterized by two mtDNA sub-lineages each of which predominated only north or south of the Chott el Jerid, a seasonally flooded saline depression that divides non-Mediterranean Tunisia. The divergence of the two mtDNA lineages was dated by mtDNA molecular clocks, indicating that the formation of the Chott el Jerid is unlikely to have been the barrier generating the vicariant evolution of the two lineages of A. australis, although it may have impeded their mixing following secondary contact. Both regional mtDNA lineages were found in A. australis hector and A. australisgarzonii, indicating that these two morphological forms are neither monophyletic nor geographically isolated and, therefore, should not be treated as species or subspecies. It is recommended that no subspecies of A. australis should be recognized in North Africa and toxicologists should cease the taxonomic error of referring to a species “Androctonus australis Hector”. The morphological form “hector” has no proven association with an increased risk of scorpionism compared with “garzonii”. However, it might be prudent to produce anti-venom in Tunisia by using both morphological forms of A. australis collected each side of the Chott el Jerid, because of the evidence for regional variation in toxins. The highest risk for scorpion stings occurs in the central region, where the new diagnostic markers should be used to discover any association between Androctonus species and scorpionism.

Reference:
Ben Othmen A, Said K, Mahamdallie SS, Testa JM, Haouas Z, Chatti N, et al. Phylogeography of Androctonus species (Scorpiones: Buthidae) in Tunisia: Diagnostic characters for linking species to scorpionism. Acta Trop. 2009;112(1):77-85. [Subscription required for full text]

Family Buthidae

Redescription and new information about the little known scorpion Buthiscus bicalcaratus from Northern Africa

 

Faraj Aboshaala and co-workers have recently published an article with a redescription and updated information about the little known scorpion Buthiscus bicalcaratus Birula, 1905 (Buthidae) based on new materials from Libya.

Abstract:
The monotypic genus Buthiscus was described by Birula (1905) with the species Buthiscus bicalcaratus from the Sahara Desert of southern Tunisia. Until now, huge gaps exist in the knowledge of this species which is classified as endemic to North Africa. This paper aims to enrich the existing knowledge on this poorly known species with redescribing specimens of both sexes collected from Libya using widely illustrated redescription, in light of modern standards ruling the taxonomy of scorpions.

Reference:
Aboshaala F, Yağmur EA, Sadine SE, Ghaliow M, Badry A. On the poorly known species Buthiscus bicalcaratus Birula, 1905 (Scorpiones: Buthidae). Serket. 2022;18(3):263-73.

Thanks to Ersen Yagmur for sending me this article!

A revision of the genus Buthacus from the Middle East with several taxonomical changes

 

The Sand Scorpions, also known as the genus Buthacus Birula, 1908 (Buthidae) are widespread in in the sandy deserts of the Palearctic, from West Africa to India. No modern revision has been done for this sand-loving genus.

Shlomo Cain and co-workers have now published a systematic revision of the Buthacus species of the Levant (the Middle East including Syria, Lebanon, Jordan, Israel, the Palestinian territories, and the Sinai Peninsula (Egypt)). 

Here are the taxonomical highlights:

New species:

Buthacus amitaii Caine, Gefen & Prendini, 2021 (Israel)

Buthacus arava Caine, Gefen & Prendini, 2021 (Israel and Jordan)

Buthacus levyi Caine, Gefen & Prendini, 2021 (Egypt, Israel and maybe Libya)

New species status/re-validations:

Buthacus armasi Lourenço, 2013 (Southern Algeria)

Buthacus spatzi (Birula, 1911) (Southern Tunisia and western Libya)

Buthacus fuscata Pallary, 1929 (Southern Algeria)

Buthacus nitzani Levy et al., 1973 (Israel and probably also in the Sinai Peninsula (Egypt))

Buthacus tadmorensis (Simon, 1892) (Iran, Iraq, Jordan, Syria, and Turkey)*

Buthacus yotvatensis Levy et al., 1973 (Israel and Jordan)

*) B. tadmorensis was listed as a valid species in The Scorpion Files before this article. It seems that the 2005 synonymization was missed by me.

Synonymizations:

Buthacus macrocentrus (Ehrenberg, 1828) synonymized with Buthacus leptochelys (Ehrenberg, 1829)

See abstract and article for more results and details.

The article has an updated identification key for the genus.

Abstract:
Scorpions of the genus Buthacus Birula, 1908 (Buthidae C.L. Koch, 1837), commonly known as “sand scorpions,” are widespread in the sandy deserts of the Palearctic, from West Africa to India. Although many new species of Buthacus were described in recent years, no modern revision exists for the genus and the limits of many infrageneric taxa remain unclear. The present contribution addresses the species of Buthacus recorded from the Levant, defined here as the region of the Middle East including Syria, Lebanon, Jordan, Israel, the Palestinian territories, and the Sinai Peninsula (Egypt). Prior to this study, five species and subspecies, including several synonyms, were recognized from the region. Based on extensive new collections, a reassessment of the morphology (including multivariate statistical analysis), and a phylogenetic analysis of morphological and DNA sequence data, published elsewhere, seven species of Buthacus are now recognized from the Levant, raising the number of species in the genus to 30. Three new species are described: Buthacus amitaii, sp. nov., endemic to Israel; Buthacus arava, sp. nov., endemic to Israel and Jordan; and Buthacus levyi, sp. nov., endemic to Egypt, Israel, and perhaps Libya. Buthacus arenicola (Simon, 1885) is redescribed and restricted to northeastern Algeria and central Tunisia, and Buthacus leptochelys (Ehrenberg, 1829) redescribed and restricted to Egypt, Sudan, and perhaps Libya. Buthacus armasi Lourenço, 2013, stat. rev., from southern Algeria, and Buthacus spatzi (Birula, 1911), stat. rev., from southern Tunisia and western Libya, are revalidated, and Buthacus fuscata Pallary, 1929, stat. nov. et stat. rev., from southern Algeria, revalidated and elevated to the rank of species. Buthacus nitzani Levy et al., 1973, stat. nov., currently restricted to Israel but probably present in the Sinai Peninsula (Egypt), is elevated to the rank of species. Buthacus tadmorensis (Simon, 1892), stat. rev., recorded from Iran, Iraq, Jordan, Syria, and Turkey, and Buthacus yotvatensis Levy et al., 1973, stat. rev., endemic to Israel and Jordan, are redescribed and revalidated. Three new synonyms are presented: Androctonus (Leiurus) macrocentrus Ehrenberg, 1828 = Buthacus leptochelys (Ehrenberg, 1829), syn. nov.; Buthus pietschmanni Penther, 1912 = Buthacus tadmorensis (Simon, 1892), syn. nov.; Buthacus granosus Borelli, 1929 = Buthacus leptochelys (Ehrenberg, 1829), syn. nov. Buthacus arenicola and the seven species of Buthacus occurring in the Levant are diagnosed and illustrated to modern standards, with updated distribution maps. A list of the currently recognized species of Buthacus, and a key to identification of the species occurring in the Levant are also presented.

Reference:
Cain S, Gefen E, Prendini L. Systematic Revision of the Sand Scorpions, Genus Buthacus Birula, 1908 (Buthidae C.L. Koch, 1837) of the Levant, with Redescription of Buthacus arenicola (Simon, 1885) from Algeria and Tunisia. Bulletin of The American Museum of Natural History. 2021(450):1-134. [Open access]

Family Buthidae

Androctonus aeneas restored as a valid species and a new Androctonus from Ethiopia

The taxonomy of the genus Androctonus Ehrenberg, 1828 (Buthidae) is complicated and there have been few attempts to do a complete revision of the genus. In spite of this, there have been several adjustments and addition of new species in the last decade.

In a late 2015 article, Lourenco and co-workers discuss the taxonomical status of the until now synonymized species Androctonus aeneas C. L. Koch, 1839. The result of this investigation is that Androctonus aeneas is restored to species status. Another decision from this investigation is that Androctonus turieli Teruel & Kovarik, 2014 is considered a junior synonym of A. aeneas.

The article also described a new species from the Tigray Province in Ethiopia.

Androctonus tigrai Lourenco, Rossi & Sadine, 2015

Abstract:
New considerations are proposed on some North African species of Androctonus Ehrenberg, 1828. The status of Androctonus aeneas C. L. Koch, 1839 is revaluated and its type locality is confirmed as the area of Oran, in Algeria. Since the two original specimens used both for the description and illustration of A. aeneas are considered lost, one neotype is designated, in order to stabilize the nomenclature within the genus, according to ICZN. New data on the geographical distribution and ecology of A. aeneas are also provided and Androctonus turieli Teruel et Kovařík 2014 is considered as a junior synonym of A. aeneas. Androctonus tigrai sp. n. is also described on the basis of two males and one female collected in the Province of Tigray, in Ethiopia.

Reference:
Lourenco WR, Rossi A, Sadine SE. New data on the genus Androctonus Ehrenberg, 1828 (Scorpiones, Buthidae), with the description of a new species from Ethiopia. Aracnida - Rivista Arachnologica Italiana. 2015;1(5):11-9.

Thank to Gerard Dupre for sending me this article!

Family Buthidae

A new species of Androctonus from Tunisia

Rolando Teruel and Frantisek Kovarik have described a new species of Androctonus Ehrenberg, 1828 (Buthidae) from Tunisia.

Androctonus turieli Teruel & Kovarik, 2014

Androctonus bicolor Ehrenberg, 1828 is redescribed. This widespread species reported from Africa and the Middle East need further investigations to establish its real distribution and to see if there are hidden species within these populations.

Abstract:
We redescribe Androctonus bicolor Ehrenberg, 1828, a scorpion species widely distributed across northeast Africa and the Middle East, on the basis of the study of nine original syntypes and supplementary material from its entire distribution area. In order to stabilize nomenclature, we also designate a lectotype, update its diagnosis according to modern standards, and provide a full illustrated complement to facilitate the recognition of this species as compared to all of its congeners. Also, a new, closely related species from eastern Tunisia is described.

Reference:
Teruel R, Kovarik F. Redescription of Androctonus bicolor Ehrenberg, 1828, and Description of Androctonus turieli sp. n. from Tunisia (Scorpiones: Buthidae). Euscorpius. 2014 (186):1-15. [Free full text]

Family Buthidae

A genetic study of the medical relevant genus Androctonus in North Africa

The genus Androctonus Ehrenberg, 1828 (Buthidae) contains the most medical important scorpions of North Africa. Because of this it is very important to study the different populations of Androctonus' taxonomy, venom composition and phylogeographical patterns.

Coelho and co-workers have now published an interesting study on the genetics of several species and populations in North Africa. This paper show many important results and will be an important basis for further studies into the taxonomy and the venom of the different taxa. See abstract for further details.

Abstract:
The genus Androctonus, commonly known as fat-tailed scorpions, contains 22 species distributed from Togo and Mauritania in the west, North Africa, through the Middle East and to as far east as India. With 13 species, a substantial amount of this genus’ diversity occurs in North Africa, which is a major hotspotof scorpion sting incidents. Androctonus are among the most medically relevant animals in North Africa.Since venom composition within species is known to vary regionally, the improvement of therapeutic management depends on a correct assessment of the existing regional specific and sub-specific variation. In this study, we assessed the phylogeographical patterns in six species of Androctonus scorpions from North Africa using mitochondrial DNA markers. We sequenced COX1, 12S, 16S and ND1 genes from110 individuals. Despite lacking basal resolution in the tree, we found taxonomical and geographically coherent clades. We discovered deep intraspecific variation in the widespread Androctonus amoreuxi and Androctonus australis, which consisted of several well-supported clades. Genetic distances between some of these clades are as high as those found between species. North African A. australis have a deep split in Tunisia around the Chott el-Djerid salt-lake. A novel split between A. amoreuxi scorpions was found in Morocco. We also found deep divergences in Androctonus mauritanicus, corresponding to areas attributed to invalidated subspecies. In addition we uncovered a clade of specimens from coastal south Morocco, which could not be ascribed to any know species using morphological characters. Based on these findings we recommend a reassessment of venom potency and anti-venom efficacy between these deep intraspecific divergent clades.

Reference:
Coelho P, Sousa P, Harris DJ, van der Meijden A. Deep intraspecific divergences in the medically-relevant fat-tailed scorpions (Androctonus, Scorpiones). Acta Trop. 2014 Feb 10;134:43-51. [Subscritpion required for full text]

Thanks to Arie van der Meijden for sending me their article!

Family Buthidae

Phylogeography of the highly complex genus Buthus

Phylogenetic relationships of Buthus in a recently published study in African Zoology.

The genus Buthus Leach, 1815 is probably one of the most speciose, widespread and taxonomical complex taxa in the family Buthidae. In recent years, many species have been described, but the taxonomic and phylogenetic status of the genus is far from resolved.

Diana Pedroso and co-workers have now published an extensive phylogeographic analysis of the genus Buthus based on genetic studies. One conclusion of this study is that there is a lack of congruence between morphologically defines species and the genetic lineages identified in this study. This is a major hindrance in the study of the complex Buthus genus.

Abstract:
The distribution of the scorpion genus Buthus Leach, 1815 includes southwestern Europe, North and Central Africa and extends east towards the Arabian Peninsula. Phylogenetic relationships within the genus are complex and remain partially unresolved despite several previous assessments. A set of three mitochondrial markers, 12s, 16s and CO1, revealed the presence of five well-supported clades: three clades endemic to Morocco, one clade distributed across the Maghreb region and southwestern Europe and one endemic to Tunisia and Algeria. Morocco presents high levels of endemism and appears to be the centre of diversity for the genus. Further differentiation was found within the clade distributed in Tunisia and Algeria, with the discovery of new phylogenetic patterns. In addition, a phylogeny combining all published CO1 data for the genus emphasized the ongoing complex situation regarding the genus’ taxonomy. Highly similar sequences were attributed to different species by different authors throughout the tree, and no differentiated monophyletic species could be resolved. This lack of congruence between morphologically defined species and genetic lineages is a major hindrance in the study of the highly complex genus Buthus.

Reference:
Pedroso D, Sousa P, Harris DJ, Van der meijden A. Phylogeography of Buthus Leach, 1815 (Scorpiones: Buthidae): a multigene molecular approach reveals a further complex evolutionary history in the Maghreb. African Zoology. 2013;48(2):298-308. [Free full text]

Thanks to Arie Van der Meijden for sending me his paper!

Euscorpius sicanus in Tunisia is natural and not recently introduced

Euscorpius sicanus from Italy. Photo: Jan Ove Rein (C)

The presence of Euscorpius (Euscorpiidae) in some areas in North Africa has been known for many years. These populations have been regarded of many as introduced by humans, but some have raised the questions if they represented isolated relict populations.

Matt Graham and co-workers have now published a DNA barcoding study of Euscorpius sicanus (C. L. Koch, 1837) from Tunisia. By comparing specimens from Tunisia with conspecifics from Malta, Sardinia and Greece, they have showed that the North African populations of this species were probably not recently introduced and instead represent an ancient and isolated natural population. Interestingly, analysis of the data suggests that the isolation between the African and European populations happened in the timeframe when scientists think that the Mediterranean basin was refilled after the "Messinan salinity crisis" (late Miocene).

Abstract:
We used a DNA barcoding marker (mitochondrial cox1) to investigate the controversial natural occurrence of Euscorpius sicanus (C.L. Koch) in North Africa. We tested this hypothesis by comparing a sample collected from a mountain in Tunisia to disjunct populations in Sardinia, Malta, and Greece. Using these samples, and a few additional Euscorpius spp. from southern Europe as outgroups, we reconstructed the maternal phylogeny. We then used a molecular clock to place the phylogeny in a temporal context. The Tunisian sample grouped closest to a specimen from Sardinia, with both being more distantly related to E. sicanus from Malta, which is known to be genetically similar to samples from Sicily. Molecular clock estimates suggest an ancient disjunction across the Mediterranean Sea, with the divergence between samples from Sardinia and Tunisia estimated to have occurred between the Late Miocene and late Pliocene. The divergence date (mean = 5.56 Mya) closely corresponds with the timing of a sudden refilling of the Mediterranean Sea after it had evaporated during the Messinian salinity crisis. This rapid influx of water, in conjunction with tectonic activity, could have sundered connections between Euscorpius in North Africa and what is now the island of Sardinia. These results provide yet another case in which DNA barcodes have proven useful for more than just identifying and discovering species.

Reference:
Graham MR, Stoev P, Akkari N, Blagoev G, Fet V. Euscorpius sicanus (Scorpiones: Euscorpiidae) from Tunisia: DNA barcoding confirms ancient disjunctions across the Mediterranean Sea. Serket. 2012;13(1/2):16-26.

Thanks to Matt Graham for sending me their paper!

Scorpion stings in children in Tunisia

As mentioned in a previous posting, children are more vulnerable to scorpion stings than adults. Bahloul and co-workers have now published an extensive study of scorpion envenomation among 685 children in Tunisia.

The most dangerous species in the study area were Androctonus australis and "Buthus occitanus" [The former Buthus occitanus and subspecies in North Africa has been split into new several new species and it is not possible for me to say which species that may be the one(s) involved in serious envenomations in Tunisa].

Abstract:
Our objective was to characterize both epidemiologically and clinically manifestations after severe scorpion envenomation and to define simple factors indicative of poor prognosis in children. We performed a retrospective study over 13 years (1990–2002) in the medical intensive care unit (ICU) of a university hospital (Sfax-Tunisia). The diagnosis of scorpion envenomation was based on a history of scorpion sting. The medical records of 685 children aged less than 16 years who were admitted for a scorpion sting were analyzed. There were 558 patients (81.5%) in the grade III group (with cardiogenic shock and/or pulmonary edema or severe neurological manifestation [coma and/or convulsion]) and 127 patients (18.5%) in the grade II group (with systemic manifestations). In this study, 434 patients (63.4%) had a pulmonary edema, and 80 patients had a cardiogenic shock; neurological manifestations were observed in 580 patients (84.7%), 555 patients (81%) developed systemic inflammatory response syndrome (SIRS), and 552 patients (80.6%) developed multi-organ failure. By the end of the stay in the ICU, evolution was marked by the death in 61 patients (8.9%). A multivariate analysis found the following factors to be correlated with a poor outcome: coma with Glasgow coma score 8/15 (odds ratio [OR] = 1.3), pulmonary edema (OR = 2.3), and cardiogenic shock (OR = 1.7). In addition, a significant association was found between the development of SIRS and heart failure. Moreover, a temperature > 39°C was associated with the presence of pulmonary edema, with a sensitivity at 20.6%, a specificity at 94.4%, and a positive predictive value at 91.7%. Finally, blood sugar levels above 15 mmol/L were significantly associated with a heart failure. In children admitted for severe scorpion envenomation, coma with Glasgow coma score edema, and cardiogenic shock were associated with a poor outcome. The presence of SIRS, a temperature > 39°C, and blood sugar levels above 15 mmol/L were associated with heart failure. 8/15, pulmonary

Reference:
Bahloul M, Chabchoub I, Chaari A, Chtara K, Kallel H, Dammak H, et al. Scorpion envenomation among children: clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg. 2010 Nov;83(5):1084-92. [Subscription required for fulltext]

Several African Scorpio subspecies given species status

Scorpio maurus Linnaeus, 1758 (Scorpionidae) has for a long time been considered a very widespread and highly polymorphic species with 19 subspecies. Wilson Lourenco has now studied the African subspecies and raised several subspecies to species rank. One new species is also described from Cameroon:

S. birulai Fet, 1997 New status
S. fuliginosus (Pallary, 1928) New status
S. hesperus Birula, 1910* New status
S. mogadorensis Birula, 1910 New status
S. occidentalis Werner, 1936 New status
S. punicus Fet, 2000 New status
S. savanicola Lourenço, 2009 New species
S. weidholzi Werner, 1929 New status

Previous status for the taxa can be found in the Scorpion Files Scorpionidae updates.

Abstract:
For almost a century, Scorpio maurus L., 1758 (Scorpiones, Scorpionidae) has been considered to be no more than a widespread and presumably highly polymorphic species. Past classifications by Birula and Vachon have restricted the status of different populations to subspecific level. In the present paper, and in the light of new evidence, several African populations are now raised to the rank of species. One of these, Scorpio occidentalis Werner, 1936, is redescribed and a neotype proposed to stabilise the taxonomy of the group. A new species is also described from the savannah areas of Cameroon. This is the second to be recorded from regions outside the Sahara desert zone.

Reference:
Lourenco WR. Reanalysis of the genus Scorpio Linnaeus 1758 in sub-Saharan Africa and description of one new species from Cameroon (Scorpiones, Scorpionidae). Entomol Mitt Zool Mus Hamburg. 2009;15(181):99-113.

Thanks to professor Lourenco for sending me the paper!

Family Scorpionidae

Scorpion envenomations in Tunisia - an analysis of 951 cases

Scorpion envenomation is still a serious problem in Northern Africa, especially when children are involved. Mounir Bouaziz and several co-workers have recently published a epidemiological study and analysis of 951 sting cases during 1990 to 2002.

A summary from the study can be seen below, but I will mention here that 72 deaths were recorded (mainly children) and that the most dangerous species are Androctonus australis and Buthus tunetanus (the name Buthus occitanus is used in the study, but I'm quite sure that it is Buthus tunetanus which is the species in question (even though it is possible that other Buthus species in Tunisia also may cause serious morbidity). The "Buthus occitanus" in this study is not the same scorpion that we find in France and Spain, which is not considered dangerous to humans).

Abstract:
The aim of this retrospective descriptive study was to describe both epidemiologically and clinically manifestations following severe scorpion envenomation and to define simple predictive factors which can be used in routine practice in general Intensive Care Units (ICU) as an indicator of poor prognosis. Cases were collected from hospital patients' files during 13-year (1990-2002) period in the medical Intensive Care Unit of a university hospital (Sfax - Tunisia). The diagnosis of scorpion envenomation was based on a history of scorpion sting. Nine hundred fifty-one patients, who were admitted for a scorpion sting, were analyzed. There were 769 patients (80.8%) in the grade III group (with cardiogenic shock and/or pulmonary edema or severe neurological manifestation (coma and/or convulsion)) and 182 patients (19.2%) in the grade II group (with systemic manifestations). Scorpion envenomation is more frequent in summer; indeed 82.3% of our patients were admitted between June and September. The mean age (+/-SD) was 14.7 +/- 17.4 years, ranging from 0.5 to 90 years. In this study 739 patients (77.8%) had neuromuscular signs, 700 patients (73.6%) had gastrointestinal signs and 585 patients (61.5%) had a pulmonary edema, while 195 patients (20.5%) had a cardiogenic shock. The mean blood sugar on admission was at 11.32 +/- 5.66 mmol/l, a high blood sugar level (>11 mmol/l) was observed in 39% of cases. The mean blood urea was at 7.1 +/- 3.2 mmol/l, it was above 10 mmol/l in 10.7% of cases. The mean of leucocytes was at 17 418 +/- 7833 cells/mm(3), it was above 11 000/mm(3) in 80% of cases. In the end of the stay in ICU, evolution was marked by the improvement of 879 patients (92.5%) while 72 patients (7.5%) died. A multivariate analysis found the following factors to be correlated with a poor outcome: age less than 5 years (OR = 2.27), fever >38.5 degrees C (OR = 2.79), coma with Glasgow coma score < or ="8/15" or =" 9.87)," or =" 8.46),">25 000 cells/mm3 (OR = 2.35) and blood urea >8 mmol/l (OR = 4.02). Moreover, in children group, a significant association was found between PRISM score and mortality rate, this model had a high discriminative power with an area under the ROC curve at 0.93. In the adult patients a significant association was found between SAPS II score and mortality rate, this model had a high discriminative power with an area under the ROC curve at 0.82. In summary, in severe scorpion envenomation, age less than 5 years, fever >38.5 degrees C, coma with Glasgow coma score < or ="8/15,">25 000 cells/mm3 and blood urea >8 mmol/l were associated with a poor outcome.

Peoples considering Androctonus australis as a suitable pet should pay attention to this study.

Reference:
Bouaziz M, Bahloul M, Kallel H, Samet M, Ksibi H, Dammak H, et al. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: multivariate analysis of 951 cases. Toxicon. 2008 Dec 15;52(8):918-26. [Subscription required for fulltext]

Family Buthidae