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1.
D’Suze G , Castillo C , Sevcik C , Brazón J , Malave C , Hernandez D , Zerpa N , 2015. Scorpionism and dangerous scorpion species in Venezuela. Scorpion Venoms. Gopalakrishnakone P, Possani LD, Schwartz EF, Rodríguez de la Vega RC, eds. Switzerland AG: Springer Nature, 273–298.
-
2.
Gopalakrishnakone P , Possani LD , Schwartz E , Rodríguez de la Vega RC , 2015. Scorpion Venoms. Dordrecht, The Netherlands: Springer.
-
3.
Miranda R et al.2021. Guía Práctica de Artrópodos Venenosos y/o Causantes de Alergia de Panamá: Alacranes, Arañas y Ácaros, 1st edition. Panama, Panama: Instituto Conmemorativo Gorgas de la Salud.
-
4.
D’Suze G , Moncada S , González C , Sevcik C , Alagón A , 2007. Antigenic cross-reactivity between sixteen venoms from scorpions belonging to six genera. Clin Toxicol 45: 158–163.
-
5.
Kshirsagar V , Ahmed M , Colaco SM , 2012. Motor aphasia: a rare complication of scorpion sting. J Pediatr Neurosci. 3: 231--233.
-
6.
Mazzei de Dàvila CA, Dàvila DF, Donis JH, de Bellabarba GA, Villarreal V, Barboza JS, 2020. Sympathetic nervous system activation, antivenin administration and cardiovascular manifestations of scorpion envenomation. Toxicon 40: 1339--1346.
-
7.
Bonilha L, Cendes F, Ghizoni E, Vieira RJ, Li LM, 2004. Epilepsy due to a destructive brain lesion caused by a scorpion sting. Arch Neurol 61: 1294--1296.
-
8.
S?ğırcı A, Öztürk M, Yakıncı C, 2014. Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion. BMJ Case Reports 2014: bcr2014205091. Available at: https://doi.org/10.1136/bcr-2014-205091.
-
9.
Romero NO , Hernández TJM , 2005. Cerebral edema associated to scorpion sting: a two case sting report. J Venom Anim Toxins Incl Trop Dis 11: 594--600.
-
10.
D’Suze G , Moncada S , González C , Sevcik C , Aguilara V , Alagón A , 2003. Relationship between plasmatic levels of various cytokines, tumor necrosis factor, enzymes, glucose and venom concentration following Tityus scorpion sting. Toxicon 41: 367–375.
-
11.
Velasco-Benitez CA, 2011. Pancreatitis in children. Rev Col Gastroenterol 261: 58--64.
-
12.
Benmosbah M, Guegueniat P, Mayence C, Egmann G, Narcisse E, Gonon S, Hommel D, Kallel H, 2013. Epidemiological and clinical study on scorpionism in French Guiana. Toxicon 73: 56--62.
-
13.
Brazón J, Hughes CE, Mori J, Sevcik C, D’suze G, Watson SP, 2011. Tityus discrepans scorpion venom activates platelets through GPVI and a novel Src-dependent signaling pathway. Platelets 22: 165--172.
-
14.
Nencioni ALA, Neto EB, de Freitas LA, Dorce VAC, 2018. Effects of Brazilian scorpion venoms on the central nervous system. J Venom Anim Toxins Incl Trop Dis 24: 3.
-
15.
Prasad R, Suri S, Shambhavi, Mishra OP, 2014. Ischemic infarction of cerebral cortex in a child with scorpion sting envenomation. Indian J Pediatr 81: 705--706.
-
16.
De Sousa L, Kiriakos D, Jimenez J, Michieli D, Rodriguez C, Mirabal J, Quiroga M, 1995. Accidente cerebrovascular isquémico por emponzoñamiento escorpiónico: observación cl譩ca. SABER Rev Cons Invest Univ Oriente 7: 7--14.
-
17.
Sevcik C, D’Suze G, Díaz P, Salazar V, Hidalgo C, Azpúrua H, Bracho N, 2004. Modelling Tityus scorpion venom and antivenom pharmacokinetics. Evidence of active immunoglobulin G’s F(ab’)2 extrusion mechanism from blood to tissues. Toxicon 44: 731--741.
-
18.
Ghersy de Nieto MT et al.2000. Emponzoñamiento escorpiónico: concentración de veneno en plasma y su efecto desencadenante de la respuesta inflamatoria sistémica. Arch Venez Pueri Pediatr. 64: 150--158.
| Past two years | Past Year | Past 30 Days | |
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Ischemic Stroke in a Child after a Probable Scorpion Sting
Laura Naranjo
Laura Naranjo
Policlínica Metropolitana, Caracas, Venezuela;
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Fernando Carrillo-Villaseñor
Fernando Carrillo-Villaseñor
Tecnológico de Monterrey, Ciencias de la Salud y Escuela de Medicina, Guadalajara, Mexico;
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Gina D’Suze
Gina D’Suze
Instituto Venezolano de Investigaciones Científicas, CBB, Caracas, Venezuela;
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Carlos Sevcik
Carlos Sevcik
Instituto Venezolano de Investigaciones Científicas, CBB, Caracas, Venezuela;
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Nathan Gundacker
Nathan Gundacker
Medical College of Wisconsin, Milwaukee, Wisconsin;
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Amy Rao
Amy Rao
University of Colorado, Anschutz Medical Center, Aurora, Colorado;
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Carlos Franco-Paredes
Carlos Franco-Paredes
University of Colorado, Anschutz Medical Center, Aurora, Colorado;
Hospital Infantil de México, Federico Gomez, Mexico City, Mexico;
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Hospital Infantil de México, Federico Gomez, Mexico City, Mexico;
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José Antonio Suárez
José Antonio Suárez
Instituto Conmemorativo Gorgas de Estudios de la Salud, Investigador SNI-SENACYT, Ciudad de Panama, Panama
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ABSTRACT.
Scorpion stings are common emergencies in the tropics. Species-specific antivenom therapies are available. However, fatalities resulting from scorpion stings remain a public health concern in many settings. Children residing in rural towns and peri-urban areas represent the most vulnerable populations. Delays in the diagnosis of scorpion stings often occur as a result of the non-specific clinical presentations, which then lead to life-threatening complications. We report a 2-year-old Venezuelan boy presenting with acute pancreatitis and pulmonary edema without an identifiable cause 48 hours after his initial symptoms. We administered antivenom therapy when an undetected scorpion sting was suspected. Despite some initial clinical improvement with respect to his acute pancreatitis, pulmonary edema, and coagulation abnormalities, our patient experienced an ischemic stroke. Fortunately, our patient did demonstrate some neurological improvement. Although acute pancreatitis and pulmonary edema are known end-organ damage manifestations of the sting of Tityus in the Americas, our particular case illustrates the risk of ischemic stroke.
Author Notes
Disclosure: L. N. has been a GSK employee since 2010. G. D’Suze has been the chief operating officer of SciMeDAn since 2018. C. Sevcik is the chief executive officer of SciMeDAn.
Authors’ addresses: Laura Naranjo, Policlínica Metropolitana, Caracas, Venezuela, E-mail: naranjo.laura1@gmail.com. Fernando Carrillo-Villaseñor, Tecnológico de Monterrey, Ciencias de la Salud y Escuela de Medicina, Guadalajara, Mexico, E-mail: carrillo_888@hotmail.com. Gina D’Suze and Carlos Sevcik, Instituto Venezolano de Investigaciones Científicas, CBB, Caracas, Venezuela, E-mails: gina.dsuze@gmail.com and csevcik@ivic.ve. Nathan Gundacker, Medical College of Wisconsin, Milwaukee, WI, E-mail: nathan.gundacker@va.gov. Amy Rao, University of Colorado, Anschutz Medical Center, Aurora, CO, E-mail: amy.rao@cuanschutz.edu. Carlos Franco-Paredes, University of Colorado, Anschutz Medical Center, Aurora, CO, and Hospital Infantil de México, Federico Gomez, Mexico City, Mexico, E-mail: carlos.franco-paredes@cuanschutz.edu. José Antonio Suárez, Instituto Conmemorativo Gorgas de Estudios de la Salud, Investigador SNI-SENACYT, Ciudad de Panama, Panama, E-mail: jasuarez05@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
D’Suze G , Castillo C , Sevcik C , Brazón J , Malave C , Hernandez D , Zerpa N , 2015. Scorpionism and dangerous scorpion species in Venezuela. Scorpion Venoms. Gopalakrishnakone P, Possani LD, Schwartz EF, Rodríguez de la Vega RC, eds. Switzerland AG: Springer Nature, 273–298.
-
2.
Gopalakrishnakone P , Possani LD , Schwartz E , Rodríguez de la Vega RC , 2015. Scorpion Venoms. Dordrecht, The Netherlands: Springer.
-
3.
Miranda R et al.2021. Guía Práctica de Artrópodos Venenosos y/o Causantes de Alergia de Panamá: Alacranes, Arañas y Ácaros, 1st edition. Panama, Panama: Instituto Conmemorativo Gorgas de la Salud.
-
4.
D’Suze G , Moncada S , González C , Sevcik C , Alagón A , 2007. Antigenic cross-reactivity between sixteen venoms from scorpions belonging to six genera. Clin Toxicol 45: 158–163.
-
5.
Kshirsagar V , Ahmed M , Colaco SM , 2012. Motor aphasia: a rare complication of scorpion sting. J Pediatr Neurosci. 3: 231--233.
-
6.
Mazzei de Dàvila CA, Dàvila DF, Donis JH, de Bellabarba GA, Villarreal V, Barboza JS, 2020. Sympathetic nervous system activation, antivenin administration and cardiovascular manifestations of scorpion envenomation. Toxicon 40: 1339--1346.
-
7.
Bonilha L, Cendes F, Ghizoni E, Vieira RJ, Li LM, 2004. Epilepsy due to a destructive brain lesion caused by a scorpion sting. Arch Neurol 61: 1294--1296.
-
8.
S?ğırcı A, Öztürk M, Yakıncı C, 2014. Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion. BMJ Case Reports 2014: bcr2014205091. Available at: https://doi.org/10.1136/bcr-2014-205091.
-
9.
Romero NO , Hernández TJM , 2005. Cerebral edema associated to scorpion sting: a two case sting report. J Venom Anim Toxins Incl Trop Dis 11: 594--600.
-
10.
D’Suze G , Moncada S , González C , Sevcik C , Aguilara V , Alagón A , 2003. Relationship between plasmatic levels of various cytokines, tumor necrosis factor, enzymes, glucose and venom concentration following Tityus scorpion sting. Toxicon 41: 367–375.
-
11.
Velasco-Benitez CA, 2011. Pancreatitis in children. Rev Col Gastroenterol 261: 58--64.
-
12.
Benmosbah M, Guegueniat P, Mayence C, Egmann G, Narcisse E, Gonon S, Hommel D, Kallel H, 2013. Epidemiological and clinical study on scorpionism in French Guiana. Toxicon 73: 56--62.
-
13.
Brazón J, Hughes CE, Mori J, Sevcik C, D’suze G, Watson SP, 2011. Tityus discrepans scorpion venom activates platelets through GPVI and a novel Src-dependent signaling pathway. Platelets 22: 165--172.
-
14.
Nencioni ALA, Neto EB, de Freitas LA, Dorce VAC, 2018. Effects of Brazilian scorpion venoms on the central nervous system. J Venom Anim Toxins Incl Trop Dis 24: 3.
-
15.
Prasad R, Suri S, Shambhavi, Mishra OP, 2014. Ischemic infarction of cerebral cortex in a child with scorpion sting envenomation. Indian J Pediatr 81: 705--706.
-
16.
De Sousa L, Kiriakos D, Jimenez J, Michieli D, Rodriguez C, Mirabal J, Quiroga M, 1995. Accidente cerebrovascular isquémico por emponzoñamiento escorpiónico: observación cl譩ca. SABER Rev Cons Invest Univ Oriente 7: 7--14.
-
17.
Sevcik C, D’Suze G, Díaz P, Salazar V, Hidalgo C, Azpúrua H, Bracho N, 2004. Modelling Tityus scorpion venom and antivenom pharmacokinetics. Evidence of active immunoglobulin G’s F(ab’)2 extrusion mechanism from blood to tissues. Toxicon 44: 731--741.
-
18.
Ghersy de Nieto MT et al.2000. Emponzoñamiento escorpiónico: concentración de veneno en plasma y su efecto desencadenante de la respuesta inflamatoria sistémica. Arch Venez Pueri Pediatr. 64: 150--158.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 5288 | 485 | 40 |
| Full Text Views | 73 | 49 | 3 |
| PDF Downloads | 52 | 24 | 0 |