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Scorpion sting in children in the Jerusalem area: a review of 54 cases
A A Dudin1, A Rambaud-Cousson, A Thalji
1Department of Paediatrics, Makassed Islamic Charitable Hospital, Jerusalem, Israel.
Insights
Prompt intravenous antivenom administration for scorpion stings in children. Early treatment quickly reversed severe symptoms like respiratory distress and myocarditis, improving outcomes.
Area of Science:
- Pediatric Toxicology
- Envenomation Management
- Scorpion Sting Treatment
Background:
- Scorpion envenoming poses a significant threat to children, particularly in regions like Jerusalem.
- Severe symptoms, including respiratory distress, convulsions, and myocarditis, can rapidly develop.
- Prompt and effective treatment is crucial for improving patient prognosis.
Purpose of the Study:
- To prospectively evaluate the clinical manifestations and outcomes of scorpion envenoming in children.
- To assess the efficacy and safety of intravenous antivenom therapy.
- To establish optimal management guidelines for pediatric scorpion stings.
Main Methods:
- Prospective study of 54 children (11 months to 10 years) with scorpion envenoming.
- Detailed recording of clinical symptoms, signs, and treatment interventions.
- Analysis of factors influencing symptom severity and treatment response.
Main Results:
- 19 out of 54 children experienced severe symptoms, with respiratory distress being the most common (17 cases).
- Symptom severity was not linked to patient demographics or scorpion type, but likely to venom dose and individual susceptibility.
- Intravenous antivenom rapidly reversed symptoms with no observed side-effects.
- Two fatalities occurred in patients who did not receive intravenous antivenom.
Conclusions:
- Intravenous antivenom is highly effective in reversing severe symptoms of scorpion envenoming in children.
- Prompt intravenous administration of antivenom is recommended for all children with significant symptoms.
- Extended observation periods are necessary for pediatric patients following scorpion stings.
Abstract:
Fifty-four children from the Jerusalem area were studied prospectively following scorpion envenoming. Their ages ranged from 11 months to 10 years. Severe symptoms (convulsions, brain oedema, shock, respiratory distress and myocarditis) were encountered in 19. Respiratory distress was the main feature in 17 of the children, in two cases owing to pulmonary oedema and in a third because of adult respiratory distress syndrome and myocarditis; mechanical ventilation was required in three cases. The severity of the symptoms and signs was not related to sex, age, weight, interval between scorpion sting and admission or to the type of offending scorpion; it was most likely dependent upon the susceptibility of the individual and/or the dose of venom injected by the scorpion. Intravenous antivenom quickly reversed the symptoms, and no side-effects were seen in the patients studied. The two patients who died had not received the antivenom intravenously. We recommend that specific antivenom should be given intravenously in all children who show significant symptoms. Furthermore, a longer period of observation is necessary following scorpion sting in this age group.