SCORPION STING AND UNILATERAL PULMONARY EDEMA: A CASE REPORT
DOI:
https://doi.org/10.55519/JAMC-02-12995Keywords:
Scorpion sting, toxic myocarditis, cardiogenic shock, unilateral pulmonary edemaAbstract
A man inflicted with scorpion sting on his left big toe developed dyspnea and hypotension 6 hours later. The chest X-ray showed alveolar infiltrates only on right side with elevated Troponin-T and B-type natriuretic peptide levels. Toxic myocarditis is a rare and under-recognized but potentially fatal complication of scorpion envenomation; development of pulmonary edema only on one side is even more uncommon and can cause delay in the diagnosis. Awareness of the condition is important to guide the treatment and avert complications.
References
Lall SB, Al-Wahaibi SS, Al-Riyami MM, Al-Kharusi K. Profile of acute poisoning cases presenting to health centres and hospitals in Oman. East Mediterr Health J 2003 Sep-Nov; 9(5-6):944-954. PMID: 16450524
Oman's Ministry of Health. National Management Guidelines of Poisoning, 2018, Chapter 28 Bites and Stings [online]. Available at: https://fliphtml5.com/fmwam/dwrx/basic [Accessed Feb 23, 2024].
Santos MS, Silva CG, Neto BS, et al. Clinical and epidemiological aspects of scorpionism in the world: a systematic review. Wilderness Environ Med. 2016; 27:504-18. DOI: https://doi.org/10.1016/j.wem.2016.08.003
Chippaux JP, Goyffon M. Epidemiology of scorpionism: a global appraisal. Acta Trop. 2008; 107(2):71-9. PMID 18579104; DOI: 10.1016/j.actatropica.2008.05.021
Abd El-Aziz FZA, El Shehaby DM, Elghazally SA, Hetta HF. Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. Toxicol Rep. 2019; 6:329-335. DOI: 10.1016/j.toxrep.2019.03.004
Bahloul M, Chaari A, Dammak H, et al. Pulmonary edema following scorpion envenomation: mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol. 2013 Jan 10; 162(2):86-91. DOI: 10.1016/j.ijcard.2011.10.013. PMID: 22075406
Prakash VJ, MM Patil, Sajjan AK, et al. Acute myocarditis in children with scorpion sting envenomation. Curr Pediatr Res. 2021; 25 (4):578-582.
Fereidooni R, Shirzadi S, Ayatizadeh SH, et al. Scorpion envenomation-associated myocarditis: a systematic review. PLoS Negl Trop Dis. 2023; 17:e0011219. DOI: 10.1371/journal.pntd.0011219
Chippaux JP. Emerging options of scorpion stings. Drug Design, Development and Therapy 2012; 6:165-173. DOI: https://doi.org/10.2147/DDDT.S24754
Abroug F, Souheil E, Ouanes I, Dachraoui F, Fekih-Hassen M, Besbes LO. Scorpion-related cardiomyopathy: Clinical characteristics, pathophysiology, and treatment. Clin Toxicol (Phila). 2015 Jul; 53(6):511-8. DOI: 10.3109/15563650.2015.1030676. PMID: 25851549
Wang R, Moreau P, Deschamps A, et al. Cardiovascular effects of Buthus martensii (Karsch) scorpion venom. Toxicon. 1994; 32(2):191-200. PMID: 8153958
Attias D, Mansencal N, Auvert B, et al. Prevalence, Characteristics, and Outcomes of Patients Presenting with Cardiogenic Unilateral Pulmonary Edema. Circulation 2010; 122:1109-1115. DOI: https://doi.org/10.1161/CIRCULATIONAHA.109.934950
Handagala R, Ralapanawa U, Jayalath T. Unilateral pulmonary edema: a case report and review of the literature. J Med Case Rep. 2018; 12:219. DOI: 10.1186/s13256-018-1739-3. PMID: 30103814
Kashiura M, Tateishi K, Yokoyama T, et al. Unilateral cardiogenic pulmonary edema associated with acute mitral regurgitation. Acute Med Surg 2017: 4:119-122. DOI: https://doi.org/10.1002/ams2.234
Bompelli N, Reddy C R, Deshpande A. Scorpion bite-induced unilateral pulmonary oedema. BMJ Case Rep. 2018; 2018:bcr2018224476. DOI: 10.1136/bcr-2018-224476. PMID: 29622717
Venugopal K, Kushal DP, Shyamala G, Chand NK. Unilateral pulmonary oedema: Rare manifestation of scorpion sting. Indian J Anaesth. 2015 Jul; 59(7):452-453. DOI: 10.4103/0019-5049.160966. PMID: 26257425
Abroug F, Nouira S, Saguiga H. Envenimations scorpioniques: avancées chimiques, physiopathologiques et thérapeutiques [Monograph]. 1994. 1-68 p.
Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: randomised open label clinical trial. BMJ. 2011 Jan 5; 342:c7136. DOI: 10.1136/bmj.c7136
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