Scorpion sting-induced unilateral pulmonary edema
Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil.Revista da Sociedade Brasileira de Medicina Tropical (Impact Factor: 0.98). 06/2012; 45(3):419. DOI: 10.1590/S0037-86822012000300032
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ABSTRACT: Scorpion bite is considered as one of the common and dangerous phenomenon throughout the world. The clinical manifestations include pulmonary edema, myocardial damage, intracerebral haemorrhage, brachial plexopathy, renal failure etc. which sometimes leads to mortality. The common antivenin therapy includes anti-scorpion venom serum or prazosin. In the vast rural areas of the third world countries phytotherapy is considered as an alternative system of medicine and scorpion sting is treated with the help of medicinal botanicals. As the safety and efficacy are considered as important aspects of anti venin therapy, conventional treatment can be supported by the herbal remedy. The present review compiles a number of medicinal plants pharmacologically evaluated in vitro and/or in vivo for scorpion antivenin properties. Considering the aspects like cost effectiveness, availability, lesser side effects and development of drug resistance, plant based anti venin therapy may be considered as a possible remedy against scorpion envenomation.
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ABSTRACT: In recent years, stings of a lethal scorpion species were recorded from Jaffna Peninsula in the northern dry zone of Sri Lanka. This species was identified as Hottentotta tamulus (Scorpiones: Buthidae) which is the Indian red scorpion commonly found in Maharashtra, India. The Teaching Hospital, Jaffna recorded 84 H. tamulus stings over a year in 2012 and of them, 23 cases provided offending scorpions (proven cases). Three localities in Jaffna were recorded as hotspots of scorpion stings namely Palali, Achchuvali and Karainagar. Of the proven cases, 13 (57%) and 10 (43%) were males and females respectively and had a mean age of 30 years (SD ± 20 years). Among them, 5 (22%) were children below 12 years. In 13 (57%) patients stings occurred inside their houses including two children (40%). Six (26%) stings occurred at night when the victims were in sleep. Median time taken to arrive at the hospital from the time of stinging was 58 min (range 8–550 min). Signs of over activation of autonomic nervous system predominated the clinical picture-tachycardia in 14 (61%), high blood pressure in 11 (48%), excessive sweating in 9 (39%), excessive salivation in 5 (22%), hypotension in 4 (17%) and piloerection in 3 (13%). Children showed higher predilection to develop tachycardia – 4 (80%) and excessive salivation – 3 (60%). Priapism was not observed and 17 (74%) patients have developed intense pain at the site of sting. The commonest ECG change was tachycardia (73%) and occasional T wave inversion. Prazosin as a treatment was given to 22 (96%) patients. All patients made recovery and 13 (57%) patients left the hospital within two days. In future, there is a potential risk of spreading this species to elsewhere in the country and may disturb the ecological balance.