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Published on: October 6, 2023
Scorpion sting envenomation in children: factors affecting the outcome
Rajniti Prasad1, Om Prakash Mishra, Nisha Pandey
1Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India. rajnitip@gmail.com
Insights
Scorpion sting envenomation in children is serious. Delayed treatment and symptoms like acidosis, myocarditis, and encephalopathy significantly increase mortality risk.
Area of Science:
- Pediatric Toxicology
- Envenomation Management
- Critical Care Medicine
Background:
- Scorpion stings pose a significant health risk to children, particularly in endemic regions.
- Effective management strategies are crucial for improving outcomes in pediatric scorpion sting cases.
Purpose of the Study:
- To identify factors influencing outcomes in children with scorpion sting envenomation treated with prazosin.
- To correlate clinical presentation and treatment timing with patient prognosis.
Main Methods:
- A retrospective study of 90 children with scorpion sting envenomation over 4.5 years.
- Prazosin administered at 30 μg/kg/dose, with repeat doses every 6 hours.
- Severity grading based on local/systemic involvement; acute pulmonary edema managed per standard protocol.
Main Results:
- Common symptoms included perspiration and cold extremities; shock, myocarditis, encephalopathy, pulmonary edema, and priapism were frequent.
- Mortality rate was 8.9%. Delayed presentation (after 6 hours) significantly increased mortality.
- Metabolic acidosis, tachypnea, myocarditis, acute pulmonary edema, encephalopathy, and priapism were associated with higher mortality.
Conclusions:
- Delayed presentation (over 6 hours) is a critical factor in pediatric scorpion sting outcomes.
- Metabolic acidosis, tachypnea, myocarditis, acute pulmonary edema, and encephalopathy are significant predictors of mortality in children.
Objective:
To identify and correlate various factors affecting the outcome of children with scorpion sting envenomation treated with prazosin in a tertiary care hospital.
Methods:
The study included 90 children admitted with scorpion sting envenomation over a period of four and half year. Grading of severity was done on the basis of local or systemic involvement, and management protocol was followed as per hospital guidelines. All cases with envenomation were given prazosin at a dose of 30 μg/kg/dose;first repeat dose at 3 h followed by every 6 h till recovery. Patients with acute pulmonary edema (APE) were treated as per standard protocol.
Results:
All patients had perspiration and cold extremities. Most of them had sting over extremities except two,having over the trunk. Shock was present in 48(53.3%), whereas myocarditis, encephalopathy, pulmonary edema and priapism were present in 38(42.2%), 32(35.5%), 34(37.8%), and 28(31.1%) children, respectively. Eight (8.9%) children had died. The mean value of blood pressure, sodium and potassium among survivors and non-survivors was insignificant. Mortality was significantly higher in children presented after 6 h of bite. Patients, who had metaboloic acidosis, tachpnea, myocarditis, APE, encephalopathy and priapism had significantly higher mortality (p < 0.05).
Conclusions:
Symptoms of acidosis, tachypnea, myocarditis, APE, encephalopathy after 6 h of sting are major contributing factors affecting outcome in children with scorpion sting envenomation.
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