What is Scorpion Toxicity?
Scorpions are common insect-like creatures found everywhere except Antarctica. If they feel threatened, scorpions can use their long, flexible tails to sting anything they see as a potential danger. Many times, people accidentally come into contact with scorpions and feel the painful sting which result in the scorpion’s venom entering their body. Most of the time, scorpion stings are not dangerous, but in some cases, they can be life-threatening. When someone who has been stung by a scorpion comes to the emergency room, there are some important points doctors need to remember to safely treat the patient.
What Causes Scorpion Toxicity?
Out of approximately 1750 scorpion species worldwide, only about 25 of them can actually harm humans severely. Usually, a scorpion’s sting might hurt, but it’s not dangerous for a healthy adult. However, certain scorpions inhabiting Asia, Africa, and South America may necessitate medical attention due to their venom’s potential harmful effects.
Rather than just causing some discomfort or swelling in the area of the sting, these scorpions can cause more severe bodily reactions. These can include breaking down of red blood cells (hemolysis), bleeding (hemorrhage), and problems with the functioning of nerves and muscles (neuromuscular dysfunction). It’s important to note that while a scorpion can sting multiple times, the potency of their venom lessens with each sting.
Risk Factors and Frequency for Scorpion Toxicity
When a person gets stung by a scorpion, the effects can vary widely and depend on the type of scorpion. Some scorpions, like Centruroides and Parabuthus, can cause problems with muscles and nerves. Other types, like Buthus, Mesobuthus, and Androctonus, can cause serious heart-related problems. These severe effects are usually seen in elderly people, infants, and young children. In the United States, the scorpions that most commonly sting people are the Centruroides exilicauda and Centruroides vittatus. However, it’s reassuring to know that no scorpion-related deaths have been reported in Arizona since 1968, and treatment usually involves supportive care to manage symptoms.
Signs and Symptoms of Scorpion Toxicity
Scorpion stings usually cause inflammation and pain in the sting area. Sometimes, the venom can affect the patient’s sodium channels, leading to seizure-like symptoms. This can make diagnosis difficult, especially in cases involving infants or young children who may not be able to explain what they’re feeling. In severe cases, patients may need to be intubated (have a tube inserted into their airway to help them breathe) because the venom can cause overactivity in the muscles involved in swallowing and breathing, potentially leading to airway blockage.
In rarer cases, the venom from specific types of scorpions can affect the heart and lungs, causing rapid heartbeat, fluid build-up in the lungs, or even shock due to heart failure. There have also been instances where the area around the sting has developed tissue damage, appearing days to weeks after the initial sting.
Testing for Scorpion Toxicity
Scorpion stings are most often diagnosed by examining your symptoms and medical history. This usually involves you seeing the scorpion and the doctor seeing a skin reaction such as redness and swelling at the sting site. You may also experience numbness and weakness around the area where you were stung.
If there are worries about the scorpion venom affecting your organs, the doctor may recommend several standard lab tests. These might include a complete blood count, a comprehensive metabolic panel, coagulation tests (such as PT/INR and PTT), and a lipase test. Lipase is an enzyme released by the pancreas into the bloodstream, so a lipase test is for checking on your pancreas health. The high level of lipase can be a sign of pancreatitis, inflammation of the pancreas.
Usually, the lab tests are only done when the scorpion sting is severe. Although unusual, pancreatitis can be a complication of a scorpion sting.
Treatment Options for Scorpion Toxicity
For most people, treatment of a sting mainly involves supportive care. This can include taking over-the-counter pain relief like ibuprofen, cleaning the sting area, and making sure that your tetanus shots are up to date. After a sting, it’s important for the person to be watched for at least 4 hours, as severe symptoms can occur quickly, usually in about 14 minutes for children.
In severe cases where a person is producing a lot of saliva, experiencing muscle spasms, or behaving restlessly, quick medical intervention is needed. These people could experience severe lung swelling quickly, which may require a breathing tube to be inserted to help them breathe. The fast onset of shock may complicate this condition so dobutamine, a heart medication, may be given to improve heart function. Muscle relaxant medicines may also be given if the person has muscle stiffness.
Antivenom, a medicine that counteracts the poison, is used in certain severe cases such as where the sting causes problems with muscle or nerve function. The antivenom used is specifically for scorpion stings. It’s usually infused into a vein and can shorten the time of symptoms if given within 4 hours of the sting. If symptoms continue, more doses may be required.
The use of antivenom is generally safe, with few complications. The older version of this medicine, used until 2001, had a fairly high risk of causing severe allergies (anaphylaxis), but the newer version doesn’t have any reported cases of this problem. However, the new version can be quite costly, with some hospitals charging over $40,000 per dose. Always, supplies for dealing with potential severe allergy, including IV fluids and equipment to assist breathing, should be ready before giving antivenom.
If a person is observed for 4 hours and their symptoms are mild, they can eat and drink normally, and their pain is under control, they can usually safely go home. The newer antivenom has been shown to reduce the length of symptoms in severe stings. Despite its high cost, its use may be worth it compared to the cost of prolonged hospitalization for severe stings.
What else can Scorpion Toxicity be?
When it comes to dealing with unfamiliar illnesses or health conditions, it’s crucial to know about various possibilities including:
- Botulism
- Caterpillar Envenomation
- Centipede Envenomation
- Coral Snake Envenomation
- Diphtheria
- Emergent Management of Myasthenia Gravis
- Emergent Management of Pancreatitis
- Insect Bites
- Organophosphate Toxicity
- Rattlesnake Envenomation
- Redback Spider Envenomation
