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Clinical profile of severe scorpion envenomation in children at rural setting
Himmatrao S Bawaskar1, Promodini H Bawaskar
1Bawaskar Hospital and Research Center, Mahad, Raigad 402 301, India. himmatbawaskar@rediffmail.com
Insights
Severe scorpion stings in children often cause pulmonary edema and blood pressure changes. Early prazosin treatment showed promise in managing symptoms, though anti-scorpion venom had limited effect on cardiovascular issues.
Area of Science:
- Pediatric Toxicology
- Emergency Medicine
- Rural Health
Background:
- Severe scorpion stings are a significant health concern in children, particularly in rural areas.
- Clinical manifestations can range from pulmonary edema to severe cardiovascular compromise (hypotension/hypertension).
Purpose of the Study:
- To evaluate the clinical features of severe scorpion stings in pediatric patients.
- To assess the effectiveness of various management strategies in a rural healthcare setting.
Main Methods:
- Retrospective case series of twelve children with severe scorpion stings.
- Therapeutic interventions included oral prazosin, dobutamine infusion, and sodium nitroprusside (SNP) drip, guided by clinical presentation.
- Evaluation of anti-scorpion venom efficacy on cardiovascular manifestations.
Main Results:
- Pulmonary edema and hypotension were observed in eight children; hypertension was noted in three.
- Two fatalities occurred due to massive pulmonary edema despite SNP and dobutamine.
- Anti-scorpion venom did not prevent cardiovascular complications.
- Early administration of prazosin appeared to reduce envenomation severity.
Conclusions:
- Severe scorpion stings in children present with critical cardiopulmonary complications.
- Prazosin may be a valuable therapeutic option for managing severe scorpion envenomation in children.
- Prompt management tailored to specific symptoms is crucial in rural settings.
Abstract:
he present study is an attempt to evaluate the clinical manifestations of severe scorpion sting in children and their management at a rural setting. Twelve patients with severe scorpion sting referred from primary health center are presented in this report. Eight children had pulmonary edema and hypotension; two had pulmonary edema and hypertension while one each presented with hypertension and tachycardia in isolation. Oral prazosin, dobutamine infusion and sodium nitroprusside drip (SNP) were used as therapeutic options based on the symptomatology. Two children died of massive pulmonary edema despite use of SNP and dopamine drip. Anti scorpion venom did not prevent the cardiovascular manifestations of severe scorpion sting. Early administration of prazosin alleviated the severity of scorpion envenomation
