Scorpion bite-induced unilateral pulmonary oedema

Area of Science:

• Toxicology
• Cardiology
• Pulmonology

Background:

• Scorpion stings, particularly from the Indian red scorpion (Hottentotta tamulus), represent a significant envenomation risk.
• Severe systemic effects, including cardiovascular and respiratory compromise, can occur following envenomation.

Observation:

• A 24-year-old female presented with tachycardia, tachypnoea, hypotension, and hypoxaemia 6 hours post-scorpion sting.
• Clinical examination revealed diminished air entry and crackles in the right lung with unilateral haziness on chest X-ray.
• Echocardiography indicated myocarditis, and arterial blood gas analysis confirmed metabolic acidosis and type 1 respiratory failure.

Findings:

• The patient required intubation and mechanical ventilation due to acute respiratory failure.
• Management included inotropes, alpha-blockers, steroids, bronchodilators, diuretics, and local xylocaine infiltration.
• The patient demonstrated clinical improvement and was successfully discharged.

Implications:

• This case highlights the potential for severe cardiopulmonary complications following Indian red scorpion stings.
• Early recognition and aggressive supportive management are crucial for improving outcomes in scorpion envenomation.
• Further research into the specific mechanisms of Indian red scorpion venom toxicity is warranted.