Author:
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Isbister GK , Bawaskar HS , 2014. Scorpion envenomation. N Engl J Med 371: 457–463.
-
2.
Chippaux JP , 2012. Emerging options for the management of scorpion stings. Drug Des Devel Ther 6: 165–173.
-
3.
Delgado-Prudencio G , Cid-Uribe JI , Morales JA , Possani LD , Ortiz E , Romero-Gutiérrez T , 2022. The enzymatic core of scorpion venoms. Toxins (Basel) 14: 248.
-
4.
Reis MB , Zoccal KF , Gardinassi LG , Faccioli LH , 2019. Scorpion envenomation and inflammation: beyond neurotoxic effects. Toxicon 167: 174–179.
-
5.
Abroug F , Ouanes-Besbes L , Tilouche N , Elatrous S , 2020. Scorpion envenomation: state of the art. Intensive Care Med 46: 401–410.
-
6.
Borges A , Graham M , Candido D , Pardal P , 2021. Amazonian scorpions and scorpionism: integrating toxinological, clinical, and phylogenetic data to combat a human health crisis in the world’s most diverse rainforest. J Venom Anim Toxins Incl Trop Dis 27: e20210028.
-
7.
Borges A et al., 2020. Venom diversity in the neotropical scorpion genus Tityus: implications for antivenom design emerging from molecular and immunochemical analyses across endemic areas of scorpionism. Acta Trop 204: 105346.
-
8.
Román JP , García F , Medina D , Vásquez M , García J , Graham MR , Romero-Alvarez D , Pardal PPO , Ishikawa EAY , Borges A , 2018. Scorpion envenoming in Morona Santiago, Amazonian Ecuador: molecular phylogenetics confirms involvement of the Tityus obscurus group. Acta Trop 178: 1–9.
-
9.
Lourenço WR , Ythier E , 2017. Description of Tityus (Atreus) cisandinus sp. n. from Ecuadorian Amazonia, with comments on some related species (Scorpiones: Buthidae). Rivista Aracnologica Italiana XV: 18–34.
-
10.
Ministerio de Salud Pública del Ecuador , 2017. Manejo clínico del envenenamiento por mordeduras de serpientes venenosas y picaduras de escorpiones. Available at: https://aplicaciones.msp.gob.ec/salud/archivosdigitales/documentosDirecciones/dnn/archivos/AC_00153_2017%2021%20NOV.pdf. Accessed September 27, 2022.
-
11.
Bravo Suárez MP , Zamora Suárez A , Mondragón Cardona A , 2017. Disfunción autonómica debido a accidente escorpiónico: reporte de caso. Acta Méd Peruana 34: 49–51.
-
12.
Bahloul M , Turki O , Chaari A , Bouaziz M , 2018. Incidence, mechanisms and impact outcome of hyperglycaemia in severe scorpion-envenomed patients. Ther Adv Endocrinol Metab 9: 199–208.
-
13.
Abdel-Haleem A-HA , Meki A-RMA , Noaman HA , Mohamed ZT , 2006. Serum levels of IL-6 and its soluble receptor, TNF-α and chemokine RANTES in scorpion envenomed children: their relation to scorpion envenomation outcome. Toxicon 47: 437–444.
-
14.
Osnaya-Romero N , Acosta-Saavedra LC , Goytia-Acevedo R , Lares-Asseff I , Basurto-Celaya G , Perez-Guille G , Possani LD , Calderón-Aranda ES , 2016. Serum level of scorpion toxins, electrolytes and electrocardiogram alterations in Mexican children envenomed by scorpion sting. Toxicon 122: 103–108.
-
15.
Çağlar A , Köse H , Babayiğit A , Öner T , Duman M , 2015. Predictive factors for determining the clinical severity of pediatric scorpion envenomation cases in southeastern Turkey. Wilderness Environ Med 26: 451–458.
-
16.
Borges CM , Silveira MR , Beker MACL , Freire-Maia L , Teixeira MM , 2000. Scorpion venom-induced neutrophilia is inhibited by a PAF receptor antagonist in the rat. J Leukoc Biol 67: 515–519.
-
17.
Diaz P , Chowell G , Ceja G , D’Auria TC , Lloyd RC , Castillo-Chavez C , 2005. Pediatric electrocardiograph abnormalities following Centruroides limpidus tecomanus scorpion envenomation. Toxicon 45: 27–31.
-
18.
Barona J , Otero R , Núñez V , 2004. Aspectos toxinológicos e inmunoquímicos del veneno del escorpión Tityus pachyurus Pocock de Colombia: capacidad neutralizante de antivenenos producidos en Latinoamérica. Biomédica 24: 42–49.
-
19.
Ghalim N , El-Hafny B , Sebti F , Heikel J , Lazar N , Moustanir R , Benslimane A , 2000. Scorpion envenomation and serotherapy in Morocco. Am J Trop Med Hyg 62: 277–283.
-
20.
Rebahi H , Ba-M’hamed S , Still ME , Mouaffak Y , Younous S , Bennis M , 2022. Clinical features and prognosis of severe scorpion envenomation in children. Pediatr Int (Roma) 64: e14687.
-
21.
Amaral CFS , Rezende NA , 2000. Treatment of scorpion envenoming should include both a potent specific antivenom and support of vital functions. Toxicon 38: 1005–1007.
-
22.
Mazzei de Dàvila CA , Dàvila DF , Donis JH , de Bellabarba GA , Villarreal V , Barboza JS , 2002. Sympathetic nervous system activation, antivenin administration and cardiovascular manifestations of scorpion envenomation. Toxicon 40: 1339–1346.
-
23.
Bucaretchi F , Baracat ECE , Nogueira RJN , Chaves A , Zambrone FAD , Fonseca MRCC , Tourinho FS , 1995. Comparative study of severe scorpion envenomation in children caused by Tityus bahiensis and Tityus serrulatus. Rev Inst Med Trop São Paulo 37: 331–336.
-
24.
De Rezende NA , Dias M , Campolina D , Chavez-Olortegui C , Diniz CR , Amaral CF , 1995. Efficacy of antivenom therapy for neutralizing circulating venom antigens in patients stung by Tityus serrulatus scorpions. Am J Trop Med Hyg 52: 277–280.
-
25.
de Roodt AR et al., 2010. General biochemical and immunological characterization of the venom from the scorpion Tityus trivittatus of Argentina. Toxicon 55: 307–319.
-
26.
Zamudio F , Saavedra R , Martin BM , Gurrola-Briones G , Hérion P , Possani LD , 1992. Amino acid sequence and immunological characterization with monoclonal antibodies of two toxins from the venom of the scorpion Centruroides noxius Hoffmann. Eur J Biochem 204: 281–292.
-
27.
Torrez PP , Quiroga MM , Abati PA , Mascheretti M , Costa WS , Campos LP , França FO , 2015. Acute cerebellar dysfunction with neuromuscular manifestations after scorpionism presumably caused by Tityus obscurus in Santarem, Pará/Brazil. Toxicon 96: 68–73.
-
28.
Borges A , Morales M , Loor W , Delgado M , 2015. Scorpionism in Ecuador: first report of severe and fatal envenomings in northern Manabí by Tityus asthenes Pocock. Toxicon 105: 56–61.
-
29.
Osnaya-Romero N , de Jesus Medina-Hernández T , Flores-Hernández SS , León-Rojas G , 2001. Clinical symptoms observed in children envenomated by scorpion stings, at the children’s hospital from the State of Morelos, Mexico. Toxicon 39: 781–785.
-
30.
Abimannane A , Rameshkumar R , Satheesh P , Mahadevan S , 2018. Second dose of scorpion antivenom in children with Indian red scorpion (Mesobuthus tamulus) sting envenomation. Indian Pediatr 55: 315–318.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1890 | 1890 | 101 |
| Full Text Views | 689 | 689 | 4 |
| PDF Downloads | 116 | 116 | 8 |
Case Report: Fatal Scorpion Envenomation in a Shuar Child by Tityus cisandinus from Amazonian Ecuador: A Call for Specific Antivenom Availability in the Amazon Basin
Adolfo Borges
Adolfo Borges
Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay;
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Juan P. Román
Juan P. Román
Hospital General de Macas, Macas, Ecuador
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ABSTRACT.
Envenomation by scorpions belonging to the genus Tityus can be life threatening in the Americas, particularly in the Amazon Basin. We report a 4-month-old Ecuadorean boy of Shuar origin stung by a scorpion identified as Tityus cisandinus in the Amazonian province of Morona Santiago, presenting with pulmonary edema and systemic inflammation. We administered immunotherapy using the scorpion antivenom available in Ecuador, of Mexican origin (anti-Centruroides). Catecholamine discharge-related events such as hyperglycemia and thrombocytosis were resolved after treatment but leukocytosis did not, suggesting that factors associated with the sting-admission delay and specificity of antivenom played a role in the envenomation outcome. Cardiorespiratory arrest determined a fatal outcome, despite specific maneuvers. The case severity and the limited supply of nonspecific scorpion antivenoms in problematic areas of Amazonian Ecuador and elsewhere in northwestern Amazonia are discussed in regard to the need for specific therapeutic immunoglobulins in the area and in the Amazon Basin as a whole.
Author Notes
Authors’ addresses: Adolfo Borges, Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay, E-mail: borges.adolfo@gmail.com. Juan P. Román, Hospital General de Macas, Macas, Ecuador, E-mail: juanpitino@hotmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Isbister GK , Bawaskar HS , 2014. Scorpion envenomation. N Engl J Med 371: 457–463.
-
2.
Chippaux JP , 2012. Emerging options for the management of scorpion stings. Drug Des Devel Ther 6: 165–173.
-
3.
Delgado-Prudencio G , Cid-Uribe JI , Morales JA , Possani LD , Ortiz E , Romero-Gutiérrez T , 2022. The enzymatic core of scorpion venoms. Toxins (Basel) 14: 248.
-
4.
Reis MB , Zoccal KF , Gardinassi LG , Faccioli LH , 2019. Scorpion envenomation and inflammation: beyond neurotoxic effects. Toxicon 167: 174–179.
-
5.
Abroug F , Ouanes-Besbes L , Tilouche N , Elatrous S , 2020. Scorpion envenomation: state of the art. Intensive Care Med 46: 401–410.
-
6.
Borges A , Graham M , Candido D , Pardal P , 2021. Amazonian scorpions and scorpionism: integrating toxinological, clinical, and phylogenetic data to combat a human health crisis in the world’s most diverse rainforest. J Venom Anim Toxins Incl Trop Dis 27: e20210028.
-
7.
Borges A et al., 2020. Venom diversity in the neotropical scorpion genus Tityus: implications for antivenom design emerging from molecular and immunochemical analyses across endemic areas of scorpionism. Acta Trop 204: 105346.
-
8.
Román JP , García F , Medina D , Vásquez M , García J , Graham MR , Romero-Alvarez D , Pardal PPO , Ishikawa EAY , Borges A , 2018. Scorpion envenoming in Morona Santiago, Amazonian Ecuador: molecular phylogenetics confirms involvement of the Tityus obscurus group. Acta Trop 178: 1–9.
-
9.
Lourenço WR , Ythier E , 2017. Description of Tityus (Atreus) cisandinus sp. n. from Ecuadorian Amazonia, with comments on some related species (Scorpiones: Buthidae). Rivista Aracnologica Italiana XV: 18–34.
-
10.
Ministerio de Salud Pública del Ecuador , 2017. Manejo clínico del envenenamiento por mordeduras de serpientes venenosas y picaduras de escorpiones. Available at: https://aplicaciones.msp.gob.ec/salud/archivosdigitales/documentosDirecciones/dnn/archivos/AC_00153_2017%2021%20NOV.pdf. Accessed September 27, 2022.
-
11.
Bravo Suárez MP , Zamora Suárez A , Mondragón Cardona A , 2017. Disfunción autonómica debido a accidente escorpiónico: reporte de caso. Acta Méd Peruana 34: 49–51.
-
12.
Bahloul M , Turki O , Chaari A , Bouaziz M , 2018. Incidence, mechanisms and impact outcome of hyperglycaemia in severe scorpion-envenomed patients. Ther Adv Endocrinol Metab 9: 199–208.
-
13.
Abdel-Haleem A-HA , Meki A-RMA , Noaman HA , Mohamed ZT , 2006. Serum levels of IL-6 and its soluble receptor, TNF-α and chemokine RANTES in scorpion envenomed children: their relation to scorpion envenomation outcome. Toxicon 47: 437–444.
-
14.
Osnaya-Romero N , Acosta-Saavedra LC , Goytia-Acevedo R , Lares-Asseff I , Basurto-Celaya G , Perez-Guille G , Possani LD , Calderón-Aranda ES , 2016. Serum level of scorpion toxins, electrolytes and electrocardiogram alterations in Mexican children envenomed by scorpion sting. Toxicon 122: 103–108.
-
15.
Çağlar A , Köse H , Babayiğit A , Öner T , Duman M , 2015. Predictive factors for determining the clinical severity of pediatric scorpion envenomation cases in southeastern Turkey. Wilderness Environ Med 26: 451–458.
-
16.
Borges CM , Silveira MR , Beker MACL , Freire-Maia L , Teixeira MM , 2000. Scorpion venom-induced neutrophilia is inhibited by a PAF receptor antagonist in the rat. J Leukoc Biol 67: 515–519.
-
17.
Diaz P , Chowell G , Ceja G , D’Auria TC , Lloyd RC , Castillo-Chavez C , 2005. Pediatric electrocardiograph abnormalities following Centruroides limpidus tecomanus scorpion envenomation. Toxicon 45: 27–31.
-
18.
Barona J , Otero R , Núñez V , 2004. Aspectos toxinológicos e inmunoquímicos del veneno del escorpión Tityus pachyurus Pocock de Colombia: capacidad neutralizante de antivenenos producidos en Latinoamérica. Biomédica 24: 42–49.
-
19.
Ghalim N , El-Hafny B , Sebti F , Heikel J , Lazar N , Moustanir R , Benslimane A , 2000. Scorpion envenomation and serotherapy in Morocco. Am J Trop Med Hyg 62: 277–283.
-
20.
Rebahi H , Ba-M’hamed S , Still ME , Mouaffak Y , Younous S , Bennis M , 2022. Clinical features and prognosis of severe scorpion envenomation in children. Pediatr Int (Roma) 64: e14687.
-
21.
Amaral CFS , Rezende NA , 2000. Treatment of scorpion envenoming should include both a potent specific antivenom and support of vital functions. Toxicon 38: 1005–1007.
-
22.
Mazzei de Dàvila CA , Dàvila DF , Donis JH , de Bellabarba GA , Villarreal V , Barboza JS , 2002. Sympathetic nervous system activation, antivenin administration and cardiovascular manifestations of scorpion envenomation. Toxicon 40: 1339–1346.
-
23.
Bucaretchi F , Baracat ECE , Nogueira RJN , Chaves A , Zambrone FAD , Fonseca MRCC , Tourinho FS , 1995. Comparative study of severe scorpion envenomation in children caused by Tityus bahiensis and Tityus serrulatus. Rev Inst Med Trop São Paulo 37: 331–336.
-
24.
De Rezende NA , Dias M , Campolina D , Chavez-Olortegui C , Diniz CR , Amaral CF , 1995. Efficacy of antivenom therapy for neutralizing circulating venom antigens in patients stung by Tityus serrulatus scorpions. Am J Trop Med Hyg 52: 277–280.
-
25.
de Roodt AR et al., 2010. General biochemical and immunological characterization of the venom from the scorpion Tityus trivittatus of Argentina. Toxicon 55: 307–319.
-
26.
Zamudio F , Saavedra R , Martin BM , Gurrola-Briones G , Hérion P , Possani LD , 1992. Amino acid sequence and immunological characterization with monoclonal antibodies of two toxins from the venom of the scorpion Centruroides noxius Hoffmann. Eur J Biochem 204: 281–292.
-
27.
Torrez PP , Quiroga MM , Abati PA , Mascheretti M , Costa WS , Campos LP , França FO , 2015. Acute cerebellar dysfunction with neuromuscular manifestations after scorpionism presumably caused by Tityus obscurus in Santarem, Pará/Brazil. Toxicon 96: 68–73.
-
28.
Borges A , Morales M , Loor W , Delgado M , 2015. Scorpionism in Ecuador: first report of severe and fatal envenomings in northern Manabí by Tityus asthenes Pocock. Toxicon 105: 56–61.
-
29.
Osnaya-Romero N , de Jesus Medina-Hernández T , Flores-Hernández SS , León-Rojas G , 2001. Clinical symptoms observed in children envenomated by scorpion stings, at the children’s hospital from the State of Morelos, Mexico. Toxicon 39: 781–785.
-
30.
Abimannane A , Rameshkumar R , Satheesh P , Mahadevan S , 2018. Second dose of scorpion antivenom in children with Indian red scorpion (Mesobuthus tamulus) sting envenomation. Indian Pediatr 55: 315–318.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1890 | 1890 | 101 |
| Full Text Views | 689 | 689 | 4 |
| PDF Downloads | 116 | 116 | 8 |