N J Bergman1. 1. Wesfleur Hospital, Atlantis, W Cape.
Abstract
OBJECTIVE: To describe the epidemiological and clinical features of scorpion stings in a district with potentially lethal scorpions. DESIGN: Case series of consecutive scorpion sting victims. SETTING: Manama Hospital and all seven rural health centres in Gwanda South District, Zimbabwe (population 62500). PARTICIPANTS: All known cases of scorpion sting reporting to health centres in the district; all severe cases in which the scorpions had been identified, and who were admitted and examined by the author between September 1991 and September 1993. MAIN OUTCOME MEASURES: Description of clinical features of severe Parabathus transvaalicus scorpionism. RESULTS: Two hundred and forty-four cases, of which 184 were P. transvaalicus Purcell, 1899. Seventeen patients with severe P. transvaalicus scorpionism showed sensory and motor nerve stimulation, with generalised hyperaesthesia, weakness, ptosis, dysphagia, muscle tremors and abnormal reflexes. There was cardiac involvement, and respiration was compromised secondary to muscular weakness. Parasympathetic nervous system stimulation was seen in the absence of sympathetic stimulation, with profuse sialorrhoea, sweating and urinary retention. CONCLUSIONS: The clinical features of P. transvaalicus scorpionism are described for the first time. These resemble those of P. granulatus scorpionism which, however, has significant sympathetic nervous system stimulation, the distinguishing features being visual disturbances, anxiety, restlessness and raised blood pressure. Scorpion antivenom should be given for both. General recommendations on management of scorpion stings are given.
OBJECTIVE: To describe the epidemiological and clinical features of scorpion stings in a district with potentially lethal scorpions. DESIGN: Case series of consecutive scorpion sting victims. SETTING: Manama Hospital and all seven rural health centres in Gwanda South District, Zimbabwe (population 62500). PARTICIPANTS: All known cases of scorpion sting reporting to health centres in the district; all severe cases in which the scorpions had been identified, and who were admitted and examined by the author between September 1991 and September 1993. MAIN OUTCOME MEASURES: Description of clinical features of severe Parabathus transvaalicus scorpionism. RESULTS: Two hundred and forty-four cases, of which 184 were P. transvaalicus Purcell, 1899. Seventeen patients with severe P. transvaalicus scorpionism showed sensory and motor nerve stimulation, with generalised hyperaesthesia, weakness, ptosis, dysphagia, muscle tremors and abnormal reflexes. There was cardiac involvement, and respiration was compromised secondary to muscular weakness. Parasympathetic nervous system stimulation was seen in the absence of sympathetic stimulation, with profuse sialorrhoea, sweating and urinary retention. CONCLUSIONS: The clinical features of P. transvaalicus scorpionism are described for the first time. These resemble those of P. granulatus scorpionism which, however, has significant sympathetic nervous system stimulation, the distinguishing features being visual disturbances, anxiety, restlessness and raised blood pressure. Scorpion antivenom should be given for both. General recommendations on management of scorpion stings are given.
Authors: Carine J Marks; Gert J Muller; Dmitrij Sachno; Helmuth Reuter; Cherylynn A Wium; Catharina E Du Plessis; Daniel J Van Hoving Journal: Afr J Emerg Med Date: 2019-02-04