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Antivenin administration for Centruroides scorpion sting: risks and benefits
1Department of Medical Toxicology, Good Samaritan Medical Center, Phoenix, Arizona.
Insights
Centruroides scorpion stings can be life-threatening in young children. Antivenin administration rapidly resolved symptoms, but some patients experienced delayed serum sickness. The benefits of antivenin may outweigh risks in severe pediatric cases.
Area of Science:
- Toxicology
- Pediatric Envenomation
Background:
- Centruroides scorpion envenomation poses significant risks to young children.
- Clinical severity and treatment efficacy require further investigation.
Purpose of the Study:
- Assess envenomation severity in children under 10.
- Evaluate antivenin benefits: symptom resolution, hospitalization, and invasive intervention prevention.
- Determine hypersensitivity reaction risks.
Main Methods:
- Retrospective chart review with follow-up.
- Study population: children under 10 with severe Centruroides envenomation.
- Intervention: goat serum-derived anti-Centruroides antivenin.
Main Results:
- Envenomation can cause life-threatening neuromuscular and respiratory distress.
- Antivenin led to rapid symptom resolution in 12 treated patients.
- 58% of treated patients developed delayed rash or serum sickness.
Conclusions:
- Rapid symptom resolution and potential outpatient management justify antivenin risks in severe pediatric cases.
- Antivenin may pose unjustified risks for less severe envenomations in older individuals.
- Risk-benefit analysis is crucial for antivenin use in pediatric scorpion envenomation.
Study Objectives:
To assess the clinical severity of envenomation by the Centruroides scorpion in young children; the potential benefit of antivenin administration with regard to time to resolution of symptoms, prevention of hospitalization, and prevention of invasive intervention; and the risk of acute and delayed hypersensitivity reaction.
Design:
Retrospective chart review with follow-up contact.
Setting:
Referral toxicology management center.
Type Of Participants:
Children less than 10 years of age experiencing severe Centruroides scorpion envenomation.
Interventions:
Administration of goat serum-derived anti-Centruroides antivenin.
Measurements And Main Results:
Stings in young children may be life threatening, resulting in extreme neuromuscular activity, tachycardia, and respiratory distress. Administration of anti-Centruroides antivenin resulted in rapid resolution of all symptoms without acute reaction in all 12 patients so treated; 58% of patients treated with antivenin had a delayed onset of rash or symptoms of serum sickness.
Conclusion:
The benefit of rapid resolution of life-threatening symptoms and potential for outpatient management of severe envenomation in young children may justify the risk of acute and delayed reaction associated with antivenin use in this group. The use of antivenin for the less severe envenomation common in older children and adults may subject them to unjustified risk.