What are the physical findings characteristic of scorpion envenomation?

Updated: Nov 09, 2018
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Cerebral infarction, cerebral thrombosis, and acute hypertensive encephalopathy have been described with a variety of Buthidae scorpion envenomations.

The signs of the envenomation are determined by the scorpion species, venom composition, and the victim's physiological reaction to the venom. The signs occur within a few minutes after the sting and usually progress to a maximum severity within 5 hours. The signs last for 24-72 hours and do not have an apparent sequence. Thus, predicting the evolution of signs over time is difficult. Furthermore, a false recovery followed by a total relapse is common.

A person who has been stung by a scorpion usually has four signs, with the most common being mydriasis, nystagmus, hypersalivation, dysphagia, and restlessness. The mode of death is usually via respiratory failure secondary to anaphylaxis, bronchoconstriction, bronchorrhea, pharyngeal secretions, and/or diaphragmatic paralysis, even though venom-induced multiorgan failure may play a large role. Death can occur from toxicity or from anaphylaxis. These are two separate things, and many “nonlethal” species can cause anaphylaxis.


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