Clinical profile and outcome of scorpion sting envenomation in children at a tertiary care centre in South India

Abstract

Background: Clinical manifestations from scorpion sting envenomation ranges from mild local pain to systemic manifestation involving multiple systems. With recent protocol guided management the mortality has reduced to as low as 1% from 30% in earlier days. Objectives: The objectives of the study were to study the clinical profile and outcome of scorpion sting envenomation in children. Methodology: This prospective, observational study was conducted in tertiary care centre of South India over 1 year. On admission, detailed history and clinical examination were done and recorded. The children were graded according to the type of symptoms and signs present and managed accordingly. Statistical analysis was done using SPSS 16.0. Results: Our study included 97 children, of which children aged 1–3 years contributed to the maximum cases (47%). Male children (54.6%) were affected more than female (45.4%). Majority of the cases were from a rural area (67%). Red scorpion stings (59%) were more common, and 63% of the stings occurred in the night time. Lower limbs (54%) were the common site of sting. The most common symptom was pain (93%), and the least common was convulsion. The most common presentation was with autonomic symptoms (Grade 2–33%). The most common electrocardiogram finding was tachycardia (74%). Of the total 97 cases, 5 cases had severe pulmonary edema and required ventilator support, and all 5 cases expired. Complications like pulmonary edema were less when children received the first dose of prazosin within 6 h. Conclusion: Early hospitalization, early administration of prazosin, monitoring of vitals, management of complications, and good supportive care may reduce the morbidity and mortality due to scorpion envenomation.