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Updated: Nov 14, 2025
Author Spotlight: Optimizing Scorpion Venom Extraction for Antivenom Production
Published on: October 6, 2023
Clinical features and prognosis of severe scorpion envenomation in children
Houssam Rebahi1,2,3, Saadia Ba-M'hamed3, Megan Elizabeth Still4
1Department of Anesthesia & Intensive Care Medicine, Faculty of Medicine & Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco.
Insights
Severe scorpion stings in children pose a significant public health risk in Morocco. Diarrhea, skin marbling, respiratory distress, and low Glasgow Coma Score (GCS) are key predictors of mortality in pediatric scorpion envenomation.
Area of Science:
- Toxicology
- Pediatric Intensive Care
- Epidemiology
Background:
- Scorpionism is a major public health issue in Morocco, with *Androctonus mauretanicus* posing a lethal threat, particularly to children.
- Severe scorpion envenomation (SSE) in children can lead to critical complications and mortality.
Purpose of the Study:
- To define the clinical and epidemiological profile of severe scorpion envenomation in Moroccan children.
- To identify independent risk factors associated with mortality in pediatric SSE cases.
Main Methods:
- A retrospective cohort study involving 606 children admitted for SSE between January 2010 and July 2015.
- Data collected from the Pediatric Intensive Care Unit (PICU) of Mohammed VI Teaching Hospital.
Main Results:
- The majority of envenomed children (74%) were from rural areas, with stings predominantly occurring nocturnally during summer.
- Key mortality predictors identified include age (1-24 months), diarrhea, skin marbling, respiratory distress, and a Glasgow Coma Score (GCS) of 3-9.
- Multivariate analysis confirmed diarrhea, skin marbling, respiratory distress, and low GCS as independent risk factors for mortality.
Conclusions:
- Children are highly vulnerable to severe scorpion envenomation, with a significant risk of complications and death.
- Early recognition of clinical signs like diarrhea, skin marbling, respiratory distress, and altered consciousness (low GCS) is crucial for managing pediatric scorpion envenomation and improving outcomes.
Background:
Scorpionism is endemic and represents a real public health problem in Morocco. The most dangerous arthropod in the central area is Androctonus mauretanicus (Am) scorpion. Its venom can be lethal, especially for children. This study aimed to determine a clinico-epidemiological profile of severe scorpion envenomation among children and identify risk factors for mortality.
Methods:
This retrospective cohort study included 606 children admitted for severe scorpion envenomation (SSE) from January 2010 to July 2015 in the Pediatric Intensive Care Unit (PICU) of Mohammed VI Teaching Hospital.
Results:
The mean age of envenomed children was 6.3 ± 4.2 years. Seventy-four percent of them came from rural settings. Envenomation occurred mostly during the summer months and 78.4% of stings were nocturnal. The time between the sting and evaluation was greater than 2 h in 83% of cases. Bivariate analysis indicated that from 1 to 24 months of age (P = 0.001), hyperthermia (P = 0.022), episodes of diarrhea (P < 0.001), tachycardia (P < 0.001), abdominal distention (P < 0.001), skin marbling (P < 0.001), signs of respiratory distress (P < 0.001), irritability (P < 0.001), generalized seizures (P = 0.053), and Glasgow Coma Score (GCS) of 3 to 9 (P < 0.001) were significantly correlated with mortality. On multivariate analysis, diarrhea (P = 0.007), skin marbling (P = 0.006), and respiratory distress (P = 0.002), and GCS 3-9 (P = 0.007) were found to be independent risk factors for mortality in our patient population.
Conclusions:
Children are at high risk of developing serious complications, even death, from severe scorpion envenomation. Here we identified multiple factors that appear to increase the mortality risk in children after scorpion envenomation, including previously described central nervous system alterations.
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