Scorpion Stings Presenting to an Emergency Department in Singapore With Special Reference to Isometrus Maculatus
Department of Emergency Medicine, Changi General Hospital, Singapore, Republic of Singapore. Electronic address: . Wilderness and Environmental Medicine
(Impact Factor: 1.2).
01/2013; 24(1). DOI: 10.1016/j.wem.2012.10.001
We describe the epidemiology and clinical features of scorpion stings presenting to an emergency department in Singapore, including that of the venomous species Isometrus maculatus. A management approach to scorpion stings is proposed.
A retrospective study was done for patients from 2004 to 2009. Cases were identified by searching through emergency department records with ICD code E905, inpatient records, and the hospital toxicology service records. Identification of species was assisted by the Venom and Toxin research program at the National University of Singapore.
A total of 13 cases of scorpion stings were identified. Eleven stings occurred locally, and the remaining 2 stings occurred in neighboring countries. The most common presenting symptoms were pain (92%), numbness (31%), and weakness (23%) confined to the region of the sting. The most common clinical signs recorded were redness (77%), tenderness (77%), and swelling (46%). Only 2 patients had significant alterations of vital signs: 1 had hypertension and the other had hypotension from anaphylaxis. Three patients experienced complications (abscess formation, anaphylaxis, cellulitis) requiring inpatient management. There were no fatalities, and all patients made a good recovery. Three cases were identified to be stings from I maculatus. These cases occurred locally, and mainly had clinical features of pain, redness, and mild regional numbness.
Scorpion stings are uncommon presentations to the emergency department. Most stings cause local reactions that can be managed with supportive treatment. Stings by I maculatus were observed to cause mild, self-limiting effects.
Available from: Luc de Haro
Available from: Fariborz Ghaffarpasand
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Scorpion stings are a major public health problem in many countries, particularly in pediatrics. Children are more susceptible to severe clinical manifestations of envenomation. The aim of this study is to determine the epidemiological and clinical characteristics of pediatric scorpionism in Hormozgan province of Iran during 2012.
This was a cross-sectional study being conducted during 2010 in Hormozgan, the southern province of Iran. We included 350 patients admitted to emergency unit of the hospitals of 8 cities of Hormozgan with impression of scorpion envenomation. The clinical and epidemiological characteristics as well as the treatment and outcome were recorded.
The prevalence rate of pediatric scorpion stings in the province was 1.8 in 1000 children. The mean age of the patients was 5.75 ± 4.54 (range, 1-18) years. There were 208 (59.5%) boys and 142 (40.5%) girls among the patients. The most common site of sting was sole to knee in 94 (26.8%) followed by hand in 61 (17.4%) and fingers in 47 (13.4%). The most common presenting symptom was vomiting in 236 (67.4%) followed by localized pain in 131 (37.3%), erythema in 120 (34.2%), and edema in 119 (33.9%). The highest and lowest frequency occurred in July (17.7%) and January (3.2%), respectively. Nocturnal envenomations (53.7%) were more common than diurnal (46.3%). Most of scorpionism were mild (83.4%) that all evolved to cure, without any deaths.
The results demonstrate the pediatric scorpionism is a public health problem in Hormozgan province of Iran, and special attention should be paid to prevention and treatment.
Available from: Alireza Khatony
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Scorpion stings are an acute health problem in tropical regions. Awareness of this problem is fundamental for establishing preventive interventions, thus prompting the present study to determine the scorpion-sting incidence in tropical areas of Kermanshah province during 2008 and 2009.
In a retrospective study, all records related to scorpion sting patients from the health centers of tropical areas of Kermanshah were studied by a census and checklist. Data were analyzed by the software SPSS-16 using descriptive and inferential tests.
The incidence of scorpion stings was 334.37/100,000 inhabitants in 2008 and 339.07/100000 in 2009. Mean and standard deviation of age were 30.55 ± 16.99. Scorpion stings were more common in rural areas (59.6 %) and occurred more often in summer (52.9 %). Nearly 48 % of bites were to patients' hands and 47.5 % of patients were injured between midnight and 6 a.m. While 92.9 % of patients had mild symptoms, scorpion antivenom was prescribed to 88.8 % of victims, 94.5 % of whom were discharged after outpatient treatment. The relationship between antivenom therapy and clinical symptoms was not significant.
Due to the relatively high incidence of scorpion stings in tropical areas of Kermanshah, it is recommended that the inhabitants be educated through the mass media about how to prevent the stings and apply preliminary treatment.
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