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Author Spotlight: Optimizing Scorpion Venom Extraction for Antivenom Production
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Author Spotlight: Optimizing Scorpion Venom Extraction for Antivenom Production

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Risk-Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency

Inbal Kestenbom1, Shaked Bar-Moshe1, Gidon Test1

  • 1Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Acta Paediatrica (Oslo, Norway : 1992)
|September 19, 2025
PubMed

Insights

Children with mild scorpion envenomation rarely develop delayed symptoms, suggesting shorter emergency department observation times are safe. A risk-stratified approach can optimize care for pediatric scorpion stings.

Area of Science:

  • Pediatric Emergency Medicine
  • Toxicology
  • Clinical Pediatrics

Background:

  • Current emergency department (ED) protocols recommend 4-6 hours of observation for pediatric scorpion envenomation.
  • Limited evidence supports these guidelines, especially for asymptomatic children.

Purpose of the Study:

  • To evaluate the necessity of routine emergency department observation for children with scorpion envenomation.
  • To assess the risk of delayed systemic symptoms in pediatric patients with varying envenomation severity.

Main Methods:

  • Retrospective cohort study of 287 children in southern Israel over 15 months.
  • Utilized a validated envenomation severity score to categorize patients.
  • Compared outcomes between Grade 1 (mild) and Grade ≥2 (more severe) envenomation scores.

Main Results:

  • 83% of patients had mild envenomation; <1% developed delayed symptoms, with 99% discharged.
  • More severe envenomation cases were younger, had higher allergy prevalence, and 94% required hospitalization.
  • Delayed symptoms in mild cases resolved with conservative management.

Conclusions:

  • A risk-stratified approach considering age, time, allergies, and severity can safely shorten ED observation.
  • Children with mild scorpion envenomation symptoms have a low risk of delayed complications.
  • Optimizing ED observation time for pediatric scorpion stings is feasible.
Abstract

Keywords:
asymptomaticchildrenemergencyenvenomationobservationscorpion

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