Scorpion envenomation

Relative to treatment of snake, spider, scorpion, and other terrestrial animal envenomatlons, the treatment of most envenomatlons due to marine animals is rather primitive. This is primarily due to our knowledge of these venoms being less complete. The incidence of jellyfish envenomation amongst... 

Scorpion venom may reach systemic circulation through lymphatic transport following a sting. Of those scorpions located in the United States, Centruroides exilicauda, found in southeastern California, Arizona, Nevada, southern Utah, and southwestern New Mexico, is an example of a scorpion that can produce significant systemic toxicity following envenomation. Onset of systemic symptoms typically occurs within 4h of the sting. The metabolism of venom components is not well understood. Tissue distribution of venom is complex. 

Basic and advanced clinical life support may be required following severe envenomation by several Centruroides species. However, most scorpion stings require only local wound care. Ice may be applied to... 

Sofer S, Shahak E, and Gueron M (1994) Scorpion envenomation and antivenom therapy. Journal of Pediatrics 124 973-978. 

Horizontal-gaze nystagmus is common with a variety of dmgs and toxins, including barbiturates, ethanol, carbamazepine, phenytoin, and scorpion envenomation. Phencyclidine (PGP) may cause horizontal, vertical, and even rotatory nystagmus. 

Abroug F et al Serotherapy in scorpion envenomation a randomised controlled trial. Lancet 1999 354(9182) 906-909. [PMID 10489950] (Prospective randomized study found no benefit of antivenom for scorpion stings In Tunisia.)... 

Gibly R et al Continuous intravenous midazolam Infusion for Centruroides exilicauda scorpion envenomation. Ann Emerg Med 1999 34(5) 620-625. [PMID 10533010] (Retrospective review of 33 patients with moderate or severe scorpion envenomation treated with midazolam infusion [median dose 0.10 mg/kg/h with a range of 0.06-1.29 mg/kg/h], with resolution of agitation and abnormal muscle activity.)... 

The phenomenon of plasma sequestration and redistribution has been observed for digitalis, colchicine and phencyclidine after Fab infusion (Smith et al, 1976 Sabouraud et al, 1992 Valentine et al, 1994). Such experiments could also be used to determine the optimal route for serum administration, to test the efficiency of a precocious or a delayed serotherapy, to define the dose of antivenom for optimal efficacy and to compare the relative effectiveness of different preparations of antivenoms. Studies similar to those carried out in the case of viper envenomations could be performed in the case of envenomations by other snakes or by scorpion stings and would help to rationalize antivenom treatment. 

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