Scorpion sting in Zimbabwe

Area of Science:

• Toxicology
• Epidemiology
• Clinical Medicine

Background:

• Scorpion stings pose a significant public health concern, particularly in regions with venomous species.
• Understanding the clinical manifestations of specific scorpion envenomations is crucial for effective management.

Purpose of the Study:

• To document the epidemiological and clinical characteristics of scorpion stings in Gwanda South District, Zimbabwe.
• To describe the specific clinical features of severe envenomation by Parabathus transvaalicus.

Main Methods:

• A case series approach was employed, collecting data from consecutive scorpion sting victims.
• Information was gathered from Manama Hospital and rural health centers over a two-year period (September 1991-September 1993).
• Detailed clinical descriptions focused on severe cases, particularly those involving identified Parabathus transvaalicus.

Main Results:

• A total of 244 scorpion sting cases were recorded, with 184 attributed to Parabathus transvaalicus.
• Severe P. transvaalicus scorpionism presented with sensory and motor nerve stimulation, including generalized hyperesthesia, weakness, ptosis, dysphagia, tremors, and abnormal reflexes.
• Cardiac and respiratory compromise occurred secondary to muscular weakness, with prominent parasympathetic stimulation (sialorrhea, sweating, urinary retention) and absent sympathetic stimulation.

Conclusions:

• This study provides the first description of the clinical features of Parabathus transvaalicus scorpionism.
• The symptoms differ from Parabuthus granulatus, which exhibits sympathetic nervous system stimulation (visual disturbances, anxiety, restlessness, hypertension).
• Scorpion antivenom is recommended for both species, and general management guidelines for scorpion stings are provided.