Scorpion envenomation

Background

1. Most scorpion stings in North America result only in local pain.
2. Centruroides sculpturatus, found in AZ, NM, TX, and CA, can cause systemic toxicity.

Clinical Features

1. Local reaction
   1. Immediate and severe pain
2. Systemic reaction
   1. Uncommon but can be severe, particularly in children
   2. Cranial nerve and somatic motor dysfunction can develop:
      1. Abnormal roving eye movements, blurred vision, pharyngeal muscle incoordination
      2. Can occasionally lead to respiratory compromise
   3. Tachycardia and severe agitation can also be present
3. Without antivenom symptoms last 24-48hr

Treatment

1. Apply ice to area of sting
2. Atropine
   1. May be given for hypersalivation and respiratory distress caused
      1. Contraindicated for foreign scorpion stings because may exacerbate adrenergic effects
3. Antivenom
   1. Resolves clinical syndrome within 4hr

See Also

• Bites and Stings

Source

Tintinalli