ABSTRACT

The aim of this study was to define the clinical and laboratory manifestations of scorpion sting envenomation in childhood in the Aegean region of Turkey and to identify factors that are predictive of severe cases.

Children admitted to our emergency department due to scorpion sting envenomation between 2008 and 2015 in the Aegean region of Turkey were evaluated retrospectively. The patients were grouped according to the clinical severity. Children admitted to pediatric intensive care unit and children admitted to general pediatric ward were compared in terms of clinical and laboratory features.

A total of 23 children (median age: 60 months; 25-75 percentile: 26-98 months; minimum: 12 months, maximum: 156 months; male/female: 12/11) were evaluated. 86.9% of cases were referred to our hospital. Fourteen patients (60.9%) were given antivenom via intramuscular route. However, intramuscular antivenom was found to be ineffective. The most common findings were local erythema (82.6%), tachycardia (65.2%) and tachypnea (56.5%). The majority of children (82.6%) had severe clinical severity. Autonomic storm developed in 21.7% of patients, heart failure due to pulmonary edema in 8.7%, non-cardiac pulmonary edema in 4.3%, and heart failure developed in 4.3% of children. 60.9% of patients were admitted to the pediatric intensive care unit and mechanical ventilation support was started in 13% of them. None of the patients died. Longer time of presentation to our hospital (6 hours versus 3 hours) and higher serum glucose level (175 mg/dL versus 107 mg/dL) were determined in children who were admitted to the pediatric intensive care unit (p<0.05).

Scorpion envenomation can lead to serious consequences in children in the Aegean region of Turkey. Intramuscular injection of antivenom seems ineffective. Longer presentation time to our hospital and higher glucose level at admission were associated with the need for pediatric intensive care unit admission.

Keywords: Scorpion envenomation, antivenom, Aegean region