Scorpion sting is a condition caused by the stings of scorpions.


Causes

A scorpion pierces the skin of humans through its stinger on the tail and quickly injects the venom into the wound, causing intoxication. Its venom is called scorpion venom, is a colorless and transparent toxoprotein, and is acidic, soluble in water, ethanol, and ether. Its toxin is neurotoxin, has cholinergic and adrenergic effects, can interfere with the ion transport of axons in the process of depolarizationa, and has paralyzing effects on the respiratory center. Moreover, its venom can cause hemolysis, hemorrhage, and blood coagulation.

Figure 1 scorpion


Signs and Symptoms

Common scorpion stings only cause local burning, redness, numbness, hypersensitivity, and blisters.

Hypertoxic scorpion stings can cause not only local burning, redness, numbness, hypersensitivity, and blisters, but also generalized pain, hemorrhage, and necrosis. There are headache, dizziness, photophobia, tearing, runny nose, salivation, nausea, vomiting, bleeding from the nose, lungs, or gastrointestinal tract, oral and tongue muscle rigidity, profuse sweating, decreased or increased body temperature, blood pressure elevation followed by decline, bradycardia, inhibited speech, irritability, and even convulsions, respiratory paralysis, and respiratory failure 1 - 2 hours after being stung. Acute heart failure and coma may occur, and occasionally pancreatitis, elevated blood sugar, proteinuria, and hematuria may be present. The rapid development of symptoms within 2 - 4 hours after being stung often indicates a poor prognosis, and death may occur if treatment is not performed properly. If patients can survive for more than 48 hours, the chance of cure is greater. Death is more common in children under 6 years of age, and often occurs within 2 hours after being stung. The causes of death are mostly serious damage to vital organs. Generally, the symptoms of poisoning subside gradually in 2 days in cured patients, but the manifestations of neurological damage can last for more than 1 week.


Diagnosis

If there is a history of exposure to scorpions and clinical manifestations, the condition can be diagnosed.


Treatment

The stinger should be pulled out from the wound, and incision and vacuum sealing drainage can be applied if necessary.

The wound can be rinsed by alkaline solution, such as 5% - 10% sodium bicarbonate, 1:2000 potassium permanganate solution, and 3% ammonia.

Annular blocking with 0.25% - 0.5% procaine can be considered.

Specific scorpion antiserum can be administered.

Mild local reactions can be treated by antihistamines and analgesics orally, whereas severe reactions can be treated with 1:1000 epinephrine 0.3 - 0.5ml subcutaneously once every 10 - 15 minutes.

Muscle rigidity can be treated by 10% calcium gluconate 10ml intravenously, 5% glucose 20ml intravenously, or diazepam 5 - 10mg intravenously.

In severe cases, intravenous methylprednisolone 125mg or hydrocortisone 200 - 300mg can be administered.

Prazosin orally 0.25 mg 2 - 3 times a day is appropriate.

Intensive care may be needed if symptoms are very severe.