[Envenomations VI. Scorpionism in Africa]

Scorpionism is a serious public health problem in North Africa, sub-Saharan countries, and South Africa. The number of species involved is small, but some have large geographic areas of distribution. Fatal outcomes sometimes occur in children and young adults. In most cases the only symptom after a scorpion sting is intense, persistent pain. Appearance of digestive symptoms within a few hours after the sting (5% of cases) is a sign of severe envenomation. These symptoms can be followed by pulmonary edema and cardiovascular manifestations (arrhythmia and hypotension). Early death can occur due to cardiovascular failure (1 to 2% of untreated cases). Progression is rapid and, after a period of 24 hours, the patient is out of danger and will recover quickly with not sequels. Specific (serotherapy) and symptomatic treatment must be initiated as soon as possible after the sting. Envenomation of a child by a dangerous adult scorpion (more than 5 cm long) in summer should be considered as a medical emergency. Declining production of antivenom is a disturbing development.