Pathogenesis of cardiovascular complications in children following scorpion envenoming

Scorpion envenoming is known to produce serious complications in children, and the complications differ with different species seen in the world. Peripheral failure, hypotension, myocarditis and seizures are the serious complications related to scorpion envenoming. The pathogenesis of cardiovascular complications caused by the Buthotus (Buthus) tamulus species is likely to be related to the direct effect of the venom on the myocardium rather than to catecholamine-induced hypoxia, as reported earlier. A scorpion sting is a common event both in urban and rural areas and the complications are more severe in children than in adults. Though several species have been identified throughout the world, stings by the Buthotus tamulus species are most commonly seen in southern states of India. Many complications have been reported related to the venom of different species of scorpion but the pathogenesis of cardiovascular complications seems to differ with different species. Most of the published reports suggest that hypotension and myocarditis were frequently observed following scorpion stings, whereas, in our children, peripheral failure and hypotension are the complications observed initially. Myocarditis and other serious complications are observed only during follow-up. The complications and lethal effects of scorpion venom seen in our earlier study indicated that in children cardiovascular complications were seen more frequently than neurological or haematological complications. The aim of the present study is to identify the frequency and nature of the cardiovascular complications and the pathogenesis of myocarditis following scorpion envenoming.