Scorpion Stings and Antivenom Use in Arizona |
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| Authors: | Stephen A. Klotz Sarah Yates Shannon L. Smith Steven Dudley Justin O. Schmidt F. Mazda Shirazi |
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| Affiliation: | 1. Division of Infectious Diseases, Department of Medicine;2. Department of Entomology;3. Arizona Poison and Drug Information Center, University of Arizona, Tucson;1. UHS Southern California Medical Education Consortium, Temecula;2. Trinity GI, Temecula;1. Section of Hospital Medicine, Beth Israel Deaconess Medical Center, Boston, Mass;2. Tufts University School of Medicine, Boston, Mass;3. Beth Israel Deaconess Hospital Plymouth, Plymouth, Mass;1. Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston;2. Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar;3. Division of Cardiology, Mayo Clinic, Rochester, Minn;4. Department of Internal Medicine, St. Elizabeth''s Medical Center, Brighton, Mass;5. Section of Cardiology, Baylor School of Medicine, Houston, Tex;6. Pulse Heart Institute, Tacoma, Wash;7. Foundation for Health Care Quality, Seattle, Wash;8. Mount Sinai St. Luke''s Hospital, New York, NY;1. Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center, Houston, Texas;2. Section of Health Services Research, Department of Medicine;3. Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas;4. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee;5. Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas;6. Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Texas;7. Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas;1. Cumming School of Medicine, Department of Medicine;2. Department of Pathology and Laboratory Medicine, University of Calgary, Alb, Canada;3. Alberta Precision Laboratories, Calgary, Canada;4. Department of Community Health Sciences, University of Calgary, Alb, Canada |
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| Abstract: | BackgroundArizona's rugged desert landscape harbors many venomous animals, including a small nocturnal scorpion, Centruroides sculpturatus, whose venom can cause severe neuromotor disturbance. An effective antivenom is available at selected health care facilities in the state.MethodsWe analyzed 4398 calls of scorpion stings to the Arizona Poison and Drug Information Center (APDIC) in Tucson over a period of 3 years, from January 2017 to December 2019.ResultsWe followed 1952 (44.4%) of the victims to resolution. We excluded 2253 callers with minimal effects of the sting and 193 victims with possible toxic effects who were lost to follow-up. The most common complaints among callers were pain at the sting site in 88.9% and local numbness in 62.2%. Detailed clinical information was obtained from 593 calls from a health care facility. Neuromotor signs consistent with C. sculpuratus envenomation included nystagmus in 163 (27.5%), hypersalivation in 91 (15.3%), and fasciculations in 88 (14.8%). Antivenom (Anascorp; Rare Disease Therapeutics, Inc., Franklin, Tenn) was administered to 145 patients. Most were children <5 years old (n = 76, or 54.4%); 27 (18.6%) were 5-9 years old and 42 (30.0%) were ≥10 years of age. About half, 79 of 145 (54.5%) victims who received antivenom, met the APDIC recommended use criteria.ConclusionsPatients treated with antivenom exhibited a rapid resolution of symptoms without immediate or delayed hypersensitivity reactions. We recommend broadened availability of antivenom at sites where it is most needed. |
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| Keywords: | Antivenom Bark scorpion Fasciculations Hypersalivation Rotary nystagmus Scorpion stings |
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