SOME ASPECTS OF SYSTEMIC TOXICITY PROFILE OF SCORPION STING, A CLINICO-EXPERIMENTAL STUDY

Abstract

In Egypt, scorpion envenomation is a real public health problem especially in rural areas of Upper Egypt. It represents a major cause of morbidity and mortality especially among younger children.

No universal scoring system or treatment protocol, up till now ,have been accepted for management of scorpion envenomation due to ignorance of the physicians dealing such cases regarding pathophysiology and clinical picture of envenomation. So, this study aimed to setup a satisfactory scoring system for these cases.

The design of this study included two main parts, the clinical part and the experimental part. The clinical part was performed on cases of scorpion sting presented to P.C.C of El-Minia University hospital in a period of seven months and included 65 cases of variable presentation. The cases were chosen regardless sex and residence. Their ages were from 1-10 years old. From those 15 were diagnosed as dry sting and the remaining 50 cases with significant envenomation were divided according to the severity of clinical presentation into different grades (1-3).

Clinical assessment and blood sampling were done for every case on admission and on consequent days during their hospital stay.

The following parameters were performed, CBCs, S.Urea and creatinine, AST, ALT, LDH, CPK, CPK-MB, and CTni.

Minimal local manifestation and biochemical changes were noticed. There was prominent effect on hematological parameters in the form of decrease RBCs and Hb%, increase WBCs count. There was no prominent effect on renal profile. Evidence of cardio-toxicity was noticed either in the form of ECG changes or elevated cardiac enzymes (LDH, CPK, CPK-MB, CTni, and AST), and it was well correlated with the severity of the condition. This indicates that the Egyptian scorpion is mainly cardiotoxic.