Clinical, epidemiological and faunistic characterization of scorpionism in Azilal, Central High Atlas (Morocco).

The province of Azilal is one of the most scorpion-infested areas in Morocco. The current study aims to investigate the clinical and epidemiological characteristics of scorpion envenomation in the Azilal province, as well as to contribute to the study of its scorpio-faunistic diversity. We examined clinical and epidemiological data from 5684 scorpion stings recorded between 2017 and 2021. Prospections on the ground were carried out in the study area. The species were identified using the taxonomic keys. Distribution maps of inventoried species have been created using SIG. 5684 scorpions stings were reported in the study area, with 18 cases of deaths. Most of the cases was reported in the summer especially at night (64%). A positive significant correlation was found between scorpion stings incidence and season (P < 0.005; r = 0.56). A positive correlation was found between scorpion stings incidence and mortality (r = 0.09). Pediatric mortality was higher compared to lethality in adults (P < 0.05). A positive correlation was found between the number of stung children (Age <15 years) and the number of patients presenting clinical signs of severe envenomation (Class III) (r = 0.40). The percentage of patients that use traditional remedies was significantly higher in the rural areas (P < 0.05). Most scorpion stings occurred in human habitat (54.5%) or in their neighbourhood (24.5%). Six species were identified in the study area. The findings of this study have highlighted the extent of scorpion envenomation and have elucidated certain characteristics of the scorpio-faunistic biodiversity in the Azilal province.

Escorpionismo en pediatría: estudio descriptivo, transversal y retrospectivo de factores predictores de gravedad / Pediatric scorpionism: a descriptive, cross-sectional, and retrospective study of predictors of severity

Introducción. El emponzoñamiento por Tityus carrilloi n. sp. representa una amenaza para la vida. Según las manifestaciones clínicas, se clasifica en leve, moderado y grave. Objetivo. Comparar las características epidemiológicas y bioquímicas en niños con escorpionismo leve, moderado y grave. Población y métodos. Estudio descriptivo, transversal y retrospectivo. Se analizaron las consultas de menores de 15 años picados por Tityus carrilloi n. sp. entre enero de 2017 y diciembre de 2018 en un hospital pediátrico de tercer nivel en Santa Fe (Argentina). Resultados. Se incluyeron 524 niños, el 81 % (421) con dolor local y el 19 % (103) con manifestaciones sistémicas. Los niños con síntomas sistémicos de escorpionismo fueron más pequeños en edad que los que presentaron manifestaciones locales (p <0,001). En el invierno los niños desarrollaron 8 veces más manifestaciones sistémicas de escorpionismo y durante la primavera, 2,4 veces más que durante el verano. De los 103 niños internados, 80 fueron casos moderados y 23, graves. No hubo diferencias entre grupos en edad (p = 0,29) ni en la demora en recibir suero antiescorpiónico (p = 0,81). El tiempo de internación fue mayor en los graves (p <0,001). Los valores de glóbulos blancos o glucemia mayores a 30 000 cel/ml y 300 mg/dl respectivamente estuvieron presentes casi exclusivamente en escorpionismos graves. Conclusión. En niños picados por el escorpión Tityus carrilloi n. sp., el riesgo de desarrollar manifestaciones sistémicas fue mayor cuanto menor fue la edad y durante el invierno y la primavera. Los valores de glóbulos blancos y de glucemia fueron mayores en niños con escorpionismo grave.

Introduction. Scorpion envenomation by Tityus carrilloi n. sp. represents a threat to life. Depending on its clinical manifestations, it is classified as mild, moderate or severe. Objective. To compare the epidemiological and biochemical characteristics among children with mild, moderate, and severe scorpionism. Population and methods. Descriptive, crosssectional, and retrospective study. The consultations at a tertiary care children's hospital in Santa Fe (Argentina) of children under 15 years of age stung by Tityus carrilloi n. sp. between January 2017 and December 2018 were analyzed. Results. In total, 524 children were included, 81% (421) with local pain and 19% (103) with systemic manifestations. Children with systemic symptoms of scorpionism were younger in age than those with local manifestations (p < 0.001). In the winter, children developed 8 times more systemic manifestations of scorpionism; during the spring, 2.4 times more than during the summer. Out of the 103 hospitalized children, 80 were moderate cases and 23 severe cases. There were no differences between age groups (p = 0.29) or in the delay in receiving the anti-scorpion serum (p = 0.81). The length of hospital stay was longer among severe cases (p < 0.001). WBC and blood glucose levels higher than 30 000 cell/mL and 300 mg/dL, respectively, were present almost exclusively in severe scorpionism cases. Conclusion. In children stung by the scorpion Tityus carrilloi n. sp., the younger the age and during winter and spring, the higher the risk for systemic manifestations. WBC and blood glucose levels were higher in children with severe scorpionism.

Pediatric scorpionism: a descriptive, cross-sectional, and retrospective study of predictors of severity. / Escorpionismo en pediatría: estudio descriptivo, transversal y retrospectivo de factores predictores de gravedad.

INTRODUCTION: Scorpion envenomation by Tityus carrilloi n. sp. represents a threat to life. Depending on its clinical manifestations, it is classified as mild, moderate or severe. OBJECTIVE: To compare the epidemiological and biochemical characteristics among children with mild, moderate, and severe scorpionism. POPULATION AND METHODS: Descriptive, crosssectional, and retrospective study. The consultations at a tertiary care children's hospital in Santa Fe (Argentina) of children under 15 years of age stung by Tityus carrilloi n. sp. between January 2017 and December 2018 were analyzed. RESULTS: In total, 524 children were included, 81% (421) with local pain and 19% (103) with systemic manifestations. Children with systemic symptoms of scorpionism were younger in age than those with local manifestations (p < 0.001). In the winter, children developed 8 times more systemic manifestations of scorpionism; during the spring, 2.4 times more than during the summer. Out of the 103 hospitalized children, 80 were moderate cases and 23 severe cases. There were no differences between age groups (p = 0.29) or in the delay in receiving the anti-scorpion serum (p = 0.81). The length of hospital stay was longer among severe cases (p < 0.001). WBC and blood glucose levels higher than 30 000 cell/mL and 300 mg/dL, respectively, were present almost exclusively in severe scorpionism cases. CONCLUSIONS: In children stung by the scorpion Tityus carrilloi n. sp., the younger the age and during winter and spring, the higher the risk for systemic manifestations. WBC and blood glucose levels were higher in children with severe scorpionism.

Introducción. El emponzoñamiento por Tityus carrilloi n. sp. representa una amenaza para la vida. Según las manifestaciones clínicas, se clasifica en leve, moderado y grave. Objetivo. Comparar las características epidemiológicas y bioquímicas en niños con escorpionismo leve, moderado y grave. Población y métodos. Estudio descriptivo, transversal y retrospectivo. Se analizaron las consultas de menores de 15 años picados por Tityus carrilloi n. sp. entre enero de 2017 y diciembre de 2018 en un hospital pediátrico de tercer nivel en Santa Fe (Argentina). Resultados. Se incluyeron 524 niños, el 81 % (421) con dolor local y el 19 % (103) con manifestaciones sistémicas. Los niños con síntomas sistémicos de escorpionismo fueron más pequeños en edad que los que presentaron manifestaciones locales (p <0,001). En el invierno los niños desarrollaron 8 veces más manifestaciones sistémicas de escorpionismo y durante la primavera, 2,4 veces más que durante el verano. De los 103 niños internados, 80 fueron casos moderados y 23, graves. No hubo diferencias entre grupos en edad (p = 0,29) ni en la demora en recibir suero antiescorpiónico (p = 0,81). El tiempo de internación fue mayor en los graves (p <0,001). Los valores de glóbulos blancos o glucemia mayores a 30 000 cel/ml y 300 mg/dl respectivamente estuvieron presentes casi exclusivamente en escorpionismos graves. Conclusión. En niños picados por el escorpión Tityus carrilloi n. sp., el riesgo de desarrollar manifestaciones sistémicas fue mayor cuanto menor fue la edad y durante el invierno y la primavera. Los valores de glóbulos blancos y de glucemia fueron mayores en niños con escorpionismo grave.

Low peripheral perfusion index values may indicate the need for antivenom in the early phase of scorpion envenomation.

BACKGROUND: Scorpion envenomation may cause local symptoms as well as life-threatening situations including shock, and death. Antivenom administration is the cornerstone of therapy, meticulous patient selection is needed because of the possible side effects of the antivenom including anaphylaxis. Peripheral perfusion index (PPI) is a simple, non-invasive test that is widely used for the detection of peripheral hypoperfusion. We aimed to investigate the value of using PPI to predict the need for antivenom administration for scorpion envenomation. METHODS: This prospective observational study was conducted in the ED of a tertiary care center. We consecutively enrolled patients with scorpion envenomation on the extremities who are over 18 years old without pregnancy and a peripheral arterial disease between March 1, 2021, to October 31, 2021. Demographics included age, sex, sting zone, the time between sting and the ED admission, and vital parameters, we blindly measured PPI both on affected and contralateral extremities before any therapeutic intervention. We compared PPI levels, vital parameters, and the outcome including discharge from the ED, admission to ward or ICU, and death between patients who received antivenom and those who did not. RESULTS: Twenty-nine male (58.0%) and 21 (42.0%) female patients with scorpion envenomation were enrolled in the study. The median age was 46.5 [IQR 33.3]. Thirty-eight (76.0%) patients had Class I, 12 (24.0%) patients had Class II and III envenomation. The median duration of the ED admission after the sting was 90 [IQR 120] minutes. Antivenom was administered in 13 (26.0%) patients. PPI was significantly lower both on the affected and the contralateral extremities (p = 0.043 and p = 0.045, respectively) in patients who required antivenom. With a cut-off value of 2.4, PPI can predict the need for antivenom with a sensitivity of 61.54%, a specificity of 86.5%, a positive likelihood ratio of 4.55, a negative likelihood ratio of 0.44, a positive predictive value of 61.54%, a negative predictive value of 86.49%, and an accuracy of 80% (AUC 0.691, p < 0.05). CONCLUSION: PPI can better reflect the ongoing systemic inflammation and the need for antivenom compared to other vital parameters. Therefore, we suggest this noninvasive and objective test may have a significant role in detecting patients who need antivenom in the early phase of scorpion envenomation. However, more studies are needed to elucidate the role of PPI in scorpion envenomation.

Clinical features and prognosis of severe scorpion envenomation in children.

BACKGROUND: Scorpionism is endemic and represents a real public health problem in Morocco. The most dangerous arthropod in the central area is Androctonus mauretanicus (Am) scorpion. Its venom can be lethal, especially for children. This study aimed to determine a clinico-epidemiological profile of severe scorpion envenomation among children and identify risk factors for mortality. METHODS: This retrospective cohort study included 606 children admitted for severe scorpion envenomation (SSE) from January 2010 to July 2015 in the Pediatric Intensive Care Unit (PICU) of Mohammed VI Teaching Hospital. RESULTS: The mean age of envenomed children was 6.3 ± 4.2 years. Seventy-four percent of them came from rural settings. Envenomation occurred mostly during the summer months and 78.4% of stings were nocturnal. The time between the sting and evaluation was greater than 2 h in 83% of cases. Bivariate analysis indicated that from 1 to 24 months of age (P = 0.001), hyperthermia (P = 0.022), episodes of diarrhea (P < 0.001), tachycardia (P < 0.001), abdominal distention (P < 0.001), skin marbling (P < 0.001), signs of respiratory distress (P < 0.001), irritability (P < 0.001), generalized seizures (P = 0.053), and Glasgow Coma Score (GCS) of 3 to 9 (P < 0.001) were significantly correlated with mortality. On multivariate analysis, diarrhea (P = 0.007), skin marbling (P = 0.006), and respiratory distress (P = 0.002), and GCS 3-9 (P = 0.007) were found to be independent risk factors for mortality in our patient population. CONCLUSIONS: Children are at high risk of developing serious complications, even death, from severe scorpion envenomation. Here we identified multiple factors that appear to increase the mortality risk in children after scorpion envenomation, including previously described central nervous system alterations.

Hand ulceration.

In the American Southwest, a common problem can be diagnosed with the knowledge of the local environment and its inhabitants.

The Role of ProBNP on Prognosis in Scorpion Stings.

INTRODUCTION: Scorpion stings are a major health problem with potentially fatal consequences. Children under the age of 10 y especially face a great risk. Predicting the prognosis is important in reducing mortality and morbidity because it enables the use of early treatment options. In this study, we examine the relationship between proBNP and prognosis in scorpion stings. METHODS: This is a retrospective analysis of patients aged ≤18 y who were admitted to the child emergency service with a scorpion sting. We examined the demographical data, clinical findings, laboratory records, treatments, and results of the patients. We classified stage 1 and stage 2 scorpion envenomation as group 1 (mild-moderate) and stage 3 and 4 as group 2 (severe). A t test was used for normally distributed data, and the Mann-Whitney U test was used for nonnormally distributed data. The correlation analysis was done using the Spearman test. RESULTS: There were 32 (74%) patients in the mild-moderate group and 11 (26%) in the severe group. ProBNP 1 was significantly higher in the severe group at admission (P=0.016). There was no difference between the troponin I values (P=0.051). ProBNP 2 (12th hour) and proBNP 3 (24th hour) were higher in the severe group (P=0.001 and P=0.032, respectively). There was a negative correlation between proBNP and echocardiographic findings involving ejection fraction and shortening fraction (r=-0.703, P=0.002). CONCLUSIONS: In our study, the first proBNP values were significantly higher in the severe group. This suggests that proBNP may be beneficial in predicting prognosis.

Epidemiology of scorpionism in France: nationwide scorpion exposure.

INTRODUCTION: In France, 57 species of scorpions are described with a limited number of clinical studies. In this article, we report the epidemiology of scorpion sting events in mainland France and its overseas territories based on cases reported to the French poison-control centres (FPCC). MATERIAL AND METHOD: This retrospective multicentre study was conducted with data from FPCC's files about scorpion stings between January 1, 2011 and December 31, 2020. RESULT: Among 975 recorded files, 624 patients were included because they were stung by scorpions native to French territories. Most stings occurred along the Mediterranean coast in summer and indoors (in persons' homes) during the daytime. The scorpions were identified in 50% of cases. According to signs of envenoming, patients were divided into class III (2 cases; 1%), class II (51 cases; 8%), class I (444 cases; 71%) and asymptomatic stings (127 cases; 20%). Twelve pregnant women were stung and two of them had contractions, which triggered childbirth in one woman. Ten patients had local infections in the first week after the sting. One patient had venous thrombosis 2 days after the sting. Life-threatening scorpions, i.e., Tityus obscurus, Tityus sylvestris and Centruroides pococki, in French territories are limited to French Guiana and Lesser Antilles. Class II envenoming cases are recorded for Buthus occitanus, Euscorpius spp. in mainland France, and Isometrus maculatus in French Guiana, the Lesser Antilles (Guadeloupe and Martinique) and territories in the Indian Ocean (Mayotte and Réunion Island) and Pacific Ocean (French Polynesia). Only cases of local manifestation was reported for Belisarius xambeui in mainland France. CONCLUSION: Scorpion stings in French territories are frequently on the Mediterranean coast and French Guiana. Life-threatening cases are limited to T. obscurus, T. sylvestris and Centruroides pococki stings in French Guiana and Lesser Antilles.

Echocardiography versus cardiac biomarkers for myocardial dysfunction in children with scorpion envenomation: An observational study from tertiary care center in northern India.

OBJECTIVE: This study was done to evaluate myocardial function by 2D Echocardiography and Cardiac biomarkers (cTnI, CK-MB, BNP) changes in patients of scorpion envenomation of grade II-IV and correlate mortality of envenomed children with myocardial dysfunction. METHODS: A total of 40 patients admitted consecutively with grade II and more scorpion envenomation from October 2015 to July2018 were enrolled in the study. The data included demographics, the time of presentation, clinical features, echocardiographic findings, electrocardiographic findings, cardiac biomarker levels at admission and discharge, use of inotropic medication, oral prazosin, time of discharge, and their outcome. RESULTS: The most common ECG abnormality was sinus tachycardia 28 (70%) followed by low voltage complex 13 (32.5%) which got normalized at the time of discharge in majority. Cardiac troponin I (cTnI) levels were more than 0.1 ng/mL, suggesting myocarditis was present in 25 (62.5%) and got normalized at discharge. CK-MB levels were increased in 26 (65%) patients suggesting myocardial involvement. BNP levels were also increased in 24 (60%) patients suggesting heart failure and its value got normalized at discharge. Abnormal 2D Echo findings as reduced left ventricular ejection fraction (LVEF) was present in 18 (45%) cases suggesting myocardial dysfunction and became normal at discharge. The sensitivity, specificity, positive predictive value and negative predictive value of Cardiac troponin I (cTnI) considering ECHO cardiograph as gold standard were 100, 68.1, 72 and 100% respectively. One patient had died whose Ejection fraction was less than 30%. CONCLUSION: Echocardiography and cTnI can identify subgroup of patients, who require early aggressive therapy. Echocardiography, if not available, cardiac troponin I level can guide early therapy and indicates the prognosis.

[Envenoming: What Information Do We Need Today and How Do we Present the Data?] / Envenimations : quelles sont les informations pertinentes et comment les présenter ?

The number of papers regarding envenoming is increasing but they often miss information and presentation to assess the needs for proper management. The author suggests some criteria to make data more informative and makes recommendations to improve the presentation of the method and results used for the study, and build argued discussion.

Le nombre d'articles concernant les envenimations s'accroît, mais ils y manquent encore trop souvent les informations et la présentation nécessaires à l'évaluation des besoins pour une prise en charge appropriée. L'auteur propose quelques critères pour rendre les données plus informatives et fait des recommandations pour améliorer la présentation de la méthode et des résultats, et construire une discussion argumentée.

Vulnerabilities and clinical manifestations in scorpion envenomations in Santarém, Pará, Brazil: a qualitative study.

OBJECTIVE: To describe elements of vulnerabilities and clinical manifestations of the victims of scorpionism in Santarem-Pará. METHOD: Quantitative and qualitative study with a theoretical framework of Twenty-eight patients stung by scorpions were interviewed by applying a semi-structured instrument. Data were analyzed according to the technique of discourse analysis. RESULTS: Seventeen patients (60.7%) were male and eight (28.6%) were illiterate. Twenty-two (78.5%) patients were small farmers. This study revealed that these patients had an important individual, social and programmatic vulnerability. Interviews revealed limited knowledge about prevention and first aid after the envenomation. Programmatic vulnerability is highlighted because there is difficulty in accessing health services due to the great geographical extension of the Amazon region and also a lack of experience of the health care workers in caring for scorpion sting victims. CONCLUSION: This research accurately reveals previously described neuromuscular and sensory nervous system disorders in these victims of scorpionism. As far as we know, this is the first study that addresses the vulnerability of scorpionism using qualitative methodology.

What's eating you? bark scorpions (Centruroides exilicauda and Centruroides sculpturatus).

Centruroides is a common genus of bark scorpions in the United States with at least 21 species considered to be medically important, including the closely related Centruroides exilicauda and Centruroides sculpturatus. Stings from C exilicauda and C sculpturatus have been shown to cause fatality in children more often than in adults. More severe complications are caused by the neurotoxin released by Centruroides stings. Most stings can be managed at home, but for those patients who require treatment, antivenin has been shown to decrease time to symptom abatement.

Is there any relationship between initial hematological parameters and severity of scorpion envenomation?

BACKGROUND AND OBJECTIVES: Most cases of severe scorpion envenomation occur in children and are associated with significant morbidity and mortality. Excessive systemic inflammatory response, which leads to multiple organ involvement, is an emerging challenge during severe envenomation. The aim of this study was to investigate if there was any relationship between initial hematological parameters and severe envenomation in pediatric patients presenting with scorpion envenomation. METHOD: This study was performed retrospectively, at the pediatric emergency unit and pediatric intensive care unit of the Çukurova University Medical School in Turkey. Two hundred and fifty-seven cases with scorpion envenomation, and a control group consisting of one hundred and fifteen healthy children were included in the study. RESULTS: White blood cell, neutrophil, lymphocyte, platelet, neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) and PDW values of patients were higher than the controls (p < 0.05). Mean NLR was 3.8 ± 4.7 in patients. Patients were analyzed with the help of the decision tree model, and it was seen that in patients who had applied to hospital in less than an hour after the scorpion sting, 87.5% of the patients whose NLR value was between the 0.519-1.969 interval (below 2.1 which we found as the cut-off value) did not need to be hospitalized in the intensive care unit, 54.1% of the patients whose NLR value was higher than 1.969 needed to be hospitalized at the intensive care unit. CONCLUSIONS: Severe envenomation is associated with mortality and morbidity in children. Our findings showed that NLR seems to be a useful tool in predicting severe envenomation.

Diagnostic and Therapeutic Value of Aptamers in Envenomation Cases.

It is now more than a century since Albert Calmette from the Institut Pasteur changed the world of envenomation by demonstrating that antibodies raised against animal venoms have the ability to treat human victims of previously fatal bites or stings. Moreover, the research initiated at that time effectively launched the discipline of toxicology, first leading to the search for toxic venom components, followed by the demonstration of venoms that also contained compounds of therapeutic value. Interest from pharmaceutical companies to treat envenomation is, however, declining, mainly for economic reasons, and hence, the World Health Organization has reclassified this public health issue to be a highest priority concern. While the production, storage, and safety of antivenom sera suffer from major inconveniences, alternative chemical and technological approaches to the problem of envenomation need to be considered that bypass the use of antibodies for toxin neutralization. Herein, we review an emerging strategy that relies on the use of aptamers and discuss how close-or otherwise-we are to finding a viable alternative to the use of antibodies for the therapy of human envenomation.

First report of scorpionism caused by Tityus serrulatus, described by Lutz and Mello, 1922 (Scorpiones, Buthidae), a species non-native to the state of Pará, Brazilian Amazon.

This reports a case of scorpionism caused by Tityus serrulatus. A male adult was stung while unloading bananas at the supply center in Belém, Pará, Brazil. The bananas originated in another state (Bahia) and were brought to Belém by truck. The patient presented with pain, edema, and erythema at the sting site, and was classified as low-risk. The specimen was identified as T. serrulatus and symptomatic treatment and clinical observation were advised. The patient was discharged later without further complications. This is the first known envenomation caused by T. serrulatus, a non-native species to Pará, in the Brazilian Amazon.

First report of scorpionism caused by Tityus serrulatus, described by Lutz and Mello, 1922 (Scorpiones, Buthidae), a species non-native to the state of Pará, Brazilian Amazon

Abstract This reports a case of scorpionism caused by Tityus serrulatus. A male adult was stung while unloading bananas at the supply center in Belém, Pará, Brazil. The bananas originated in another state (Bahia) and were brought to Belém by truck. The patient presented with pain, edema, and erythema at the sting site, and was classified as low-risk. The specimen was identified as T. serrulatus and symptomatic treatment and clinical observation were advised. The patient was discharged later without further complications. This is the first known envenomation caused by T. serrulatus, a non-native species to Pará, in the Brazilian Amazon.

Fatal scorpion envenomation in a 3-month-old infant.

Scorpion envenomation is a public health problem in several countries in the tropics and subtropics, with high mortality in the severe forms involving multiple organ failure. The correlation between young age and clinical manifestations of severe scorpion envenomation is well established. We report the case of a 3-month-old infant admitted for severe scorpion envenomation who rapidly developed fatal multiple organ failure, and we discuss the different physiopathological aspects of severe scorpion envenomation.

A retrospective study of scorpionism in 11 domestic dogs and a cat in the urban area of Manizales, Colombia.

The present study analyzes cases of scorpionism in 11 dogs and a cat that were registered at a veterinary clinic in the city of Manizales, between 2009 and 2018. All eight cases where expert identification of the arthropod was possible, involved Centruroides gracilis (Latreille, 1804). None of the stings were lethal, though two cases were classified as severe envenomation and five moderate. The primary sign was local pain, in addition to lameness in all 10 cases that involved one of the limbs (83,3%, 10 of 12 cases). The other two cases had injuries involving the face. The established treatment was symptomatic with clinical and patient monitoring. Antivenom could not be used due to its high cost and scarcity. However, even the severest cases improved satisfactorily, and all patients were discharged without complication.

Escorpionismo en pacientes pediátricos internados en terapia intensiva: Serie de casos / Escorpionism in pediatric intensive care patients: Case series

El escorpionismo constituye un problema de salud pública con una incidencia en aumento en Argentina. El veneno contiene varias neurotoxinas capaces de generar una "tormenta autonómica" responsable de las manifestaciones clínicas. Los sistemas cardiovascular y respiratorio son los más afectados y su grado de compromiso determinará la morbimortalidad. Un 10 % de los casos en niños evolucionan a su forma grave. En esta serie retrospectiva, se describe la epidemiología y evolución de 17 pacientes ingresados a la Unidad de Terapia Intensiva Pediátrica entre enero de 2010 y enero de 2014. Si bien no hubo mortalidad, sí una alta morbilidad: 12 pacientes presentaron edema agudo de pulmón que requirió ventilación mecánica; 11 pacientes desarrollaron shock cardiogénico hipotensivo; 7, bajo gasto cardíaco grave y, en 6, se utilizó levosimendán por el carácter refractario de su bajo gasto.

Scorpionism is a public health problem with an increasing incidence in Argentina. The poison contains several neurotoxins capable of generating an "autonomic storm" responsible for the clinical manifestations. The cardiovascular and respiratory systems are the most affected ones and their degree of commitment will determine morbidity and mortality. A 10 % of cases in children evolve to their severe form. In this retrospective series, we describe the epidemiology and evolution of 17 patients admitted to the Pediatric Intensive Care Unit from January 2010 to January 2014. Although there was no mortality, there was a high morbidity: 12 patients had acute lung edema requiring mechanical ventilation, 11 patients developed hypotensive cardiogenic shock, 7 were under severe low cardiac output and in 6 levosimendan was used due to the low refractory output.

[Escorpionism in pediatric intensive care patients. Case series]. / Escorpionismo en pacientes pediátricos internados en terapia intensiva. Serie de casos.

Scorpionism is a public health problem with an increasing incidence in Argentina. The poison contains several neurotoxins capable of generating an "autonomic storm" responsible for the clinical manifestations. The cardiovascular and respiratory systems are the most affected ones and their degree of commitment will determine morbidity and mortality. A 10 % of cases in children evolve to their severe form. In this retrospective series, we describe the epidemiology and evolution of 17 patients admitted to the Pediatric Intensive Care Unit from January 2010 to January 2014. Although there was no mortality, there was a high morbidity: 12 patients had acute lung edema requiring mechanical ventilation, 11 patients developed hypotensive cardiogenic shock, 7 were under severe low cardiac output and in 6 levosimendan was used due to the low refractory output.

El escorpionismo constituye un problema de salud pública con una incidencia en aumento en Argentina. El veneno contiene varias neurotoxinas capaces de generar una "tormenta autonómica" responsable de las manifestaciones clínicas. Los sistemas cardiovascular y respiratorio son los más afectados y su grado de compromiso determinará la morbimortalidad. Un 10 % de los casos en niños evolucionan a su forma grave. En esta serie retrospectiva, se describe la epidemiología y evolución de 17 pacientes ingresados a la Unidad de Terapia Intensiva Pediátrica entre enero de 2010 y enero de 2014. Si bien no hubo mortalidad, sí una alta morbilidad: 12 pacientes presentaron edema agudo de pulmón que requirió ventilación mecánica; 11 pacientes desarrollaron shock cardiogénico hipotensivo; 7, bajo gasto cardíaco grave y, en 6, se utilizó levosimendán por el carácter refractario de su bajo gasto.