Socio-demographic, clinical, laboratory profile and outcome in children with scorpion envenomation

Komalatha Choppari, Santosh Kumar Soma, Suresh R. J. Thomas


Background: Aim was to study clinical, socio- demographic and laboratory profile and outcome in children with scorpion envenomation up to 12 years of age. This study conducted to provide better insights in to the socio-demographic, clinical, laboratory profile of scorpion envenomation in rural health setting in India.

Methods: This was a hospital based, prospective observational study done in children up to 12 years of age admitted in a tertiary care centre between March 2018 to April 2020 with history of scorpion envenomation, presence of sting mark or scorpion seen in vicinity of child by parents or near family members. Unknown bites or stings and cases were the clinical manifestations are not compatible with scorpion sting were excluded.

Results: During the study period, 28 children were admitted for scorpion sting. Maximum number of cases were noted in the age group of 3-6 years and there is equal distribution of cases among males and females .Majority of cases from rural areas, 46.42% of the cases had black scorpion sting, most of the stings occurred during evening time and spring season. The most common sting sites were the distal part of the extremities. Pain at the sting site and local swelling were the most common presenting symptoms. The common signs noted were tachycardia. The most common ECG changes were noted in the present study was sinus tachycardia (46.42%) fallowed by ST segment changes noted in 21.4% of children. Commonest complications noted myocarditis, pulmonary edema, myocardial dysfunction, peripheral circulatory failure. One patient died due to pulmonary edema. Majority of the cases recovered without any sequale.

Conclusions: Scorpion envenomation is a preventable emergency among children and closely associated with environmental condition, socioeconomic status and child activities. Supervised outdoor play, early hospitalization, close monitoring of vitals and management of complications and supportive care may reduce the mortality and morbidity.


Myocarditis, Pulmonary edema, Scorpion sting

Full Text:



Kumar CM. Scorpion sting, the challenge for intensives. Pak Paediatr J. 2008;32(4):192-9.

Chippaux JP, Goyffon M. Epidemiology of scorpionism: a global appraisal. Acta Trop. 2008;107(2):71-9.

Bawaskar HS, Bawaskar PH. Scorpion sting. J Assoc Physicians India. 2012;60:46-55.

Bawaskar HS, Bawaskar PH. Prazosin in management of cardiovascular manifestations of scorpion sting. Lancet. 1986;1:510-11.

Bawaskar HS. Scorpion sting and cardiovascular complications. Indian Heart J. 1977;29:4:228.

Gueron M, Yaron R. Cardiovascular manifestations of severe scorpion sting. Chest. 1970;57:156-62.

Bahloul M, Chabchoub I, Chaari A, Chatara K, Jallel H, Dammak H, et al. Scorpion envenomation among children: clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg. 2010;83:1984-92.

Amatai Y, Mines Y, Akar M, Goiten K. Scorpion sting in children. Clinical Pediatric. 1994;24:136-40.

Bosnak M, Ece A, Yolbas I. Scorpion envenomation in children in southeast turkey. Wilderness Environmental Med. 2009;20:118-24.

Bawaskar HS, Bawaksar PH. Cardiovascular manifestations of severe scorpion sting in India (review of 34 children). Annal Trop Pediatr. 1991;11:481-88.

Mahadevan S. Scorpion sting. Ind Ped. 2000;37:504-14.

Joshi SR, Sapatnekar SM. Stings and hopes: tox inomics and autonomic storm in the Indian red scorpion (mesobuthus tamulus concanesis pocock). J Assoc Physicians India. 2007;55:11-5.

Cheng D, Dattaro JA, Yakobi R. Scorpion sting. Available at Accessed on 12 August 2020.

Watt D, Simard JM. Neurotoxic proteins in scorpion venom. J Toxicol Toxin Reviewes. 1984;3:181-92.

Bawaskar HS, Bawaskar PH. Symptoms, signs and management of Indian red scorpion envenomation, Medicine update; Apicon, API, India. 1998; 475-76.

Ismail M, Elsalam MA, Morad AM. Do changes in body temperature following envenomation by the scorpion Leiurus quinquestriatus influence the course of toxicity? Toxicon. 1990;28(11):1265-84.

Prasad R, Mishra OP, Pandey N, Singh TB. Scorpion sting envenomation in children: Factors affecting the outcome. Indian J Pediatr. 2011;78:544-8.

Bawaskar HS. Scorpion sting and cardiovascular complications. Indian Heart J. 1977;29:228.

Bouaziz M, Bahloul M, Hergafi L, Kallel H, Chaari L, Hamida CB, et al. Factors associated with pulmonary edema in severe scorpion sting patients--a multivariate analysis of 428 cases. Clin Toxicol (Phila). 2006;44(3):293-300.

Biswal N, Murmu UC, Mathai B, Bakachander J, Srinivasan S. Management of scorpion sting envenomation. Pediatr Today. 1999;2(4):420-6.

Bawaskar HS, Bawaskar PH. Management of cardiovascular manifestations of poisoning by Indian red scorpion (Mesobuthus tumulus). Brit Heart J. 1992;68:478-80.

Bawaskar HS, Bawaskar PH. Clinical profile of severe scorpion envenomation in children at rural setting. Indian Pediatr. 2003;40:1072-81.

Ramesh G, Acarya A, Subrahmanyam V. A retrospective study of epidomology clinical course and treatment outcome of scorpion stimg in paediatric age group. J Evid Based Med Healthc. 2015;2(56):842-4.

Kumar CM, Naveen SV. Echocardiological evaluation and fallow-up of cardiovascular complications in children with scorpion sting in costal South India. Indian J Crit Care Med. 2015;19:42-6.

Pol R, Vanaki R, Pol M. The clinical profile and efficacy of prazosin in scorpion sting envenomation in children in north Karnataka (India). J Clin Diag Res. 2011;5:456-8.

Adiguzel S, Ozkan O, Inceoglu B. Epidemological and clinical charecteristics of scorpionism in childen in sanliurfa,Turkey. Toxicon. 2007;49:875-80.

Altinkaynak S, Ertekin V, Alp H. Scorpion envenomation in children. Turk Arch Pediar. 2002;37:48-54.

Osnaya RN, Jesus M, Hernandez T, Florez SS, Leon RG. Clinical symptoms observed in children envenomed by scorpion stings at the children’s hospital from the state of Morelos, Mexico. Toxicon. 2001;39:781-5.

Pol R, Vanaki R, Pol M. The clinical profile and efficacy of prazosin in scorpion sting envenomation in children in north Karnataka (India). J Clin Diag Res. 2011;5:456-8.

Roodt AR, Garcia SI, Salomon OD. Epidemological and clinical aspects of scorpionism by Tityus trivittatus in Argentina. Toicon. 2003;41:971-7.

Jarrar BM, Al-Rowaily MA. Epidemological aspects of scorpion sting in AI-Jouf province, Saudi Arabia. Ann Saudi Med. 2008;28:183-7.

Bosank M, Ece A, Yolbas I, Bosank V, Kaplan M, Gurkan F. Scorpion sting envenomation in children in southeast Turkey. Wilderness Environ Med. 2009;20:118-24.

Jarrar BM, Al-Rowaily MA. Epidemological aspects of scorpion sting in AI-Jouf province, Saudi Arabia .Ann Saudi Med 2008;28:183-7.

Bawaskar HS, Bawaskar PH. Sting by red scorpion (Buthotus Tamulus) in Maharashtra state, India: A clinical study. Trans Roy Soc Trop Med Hyg. 1989;83:858-60.

Biswal N, Bashir RA, Murmu UC, Mathai B, Balachander J, Srinivasan S. Outcome of scorpion sting envenomation after a protocol guided therapy. Indian J Pediatr. 2006;73:577-82.

AI Rashed MA, Olasope B. Scorpion sting in children from Northwestern area of Riyadh, Saudhi Arabia. Bahrain Medical Bulletin. 1999;1:10-2.

Cusinato DA, Souza AM, Vasconcelos F, Guimaraes LF, Leite FP, Gregorio ZM, et al. Assessment of biochemical and hematological parameters in rats injected with Tityus serrulatus scorpion venom. Toxicon. 2010;56:1477-86.

Bosnak M, Ece A, Yolbas I, Bosnak V, Kalplan M, Gurkan F. Scorpion envenomation in children in southeast turkey. Wilderness Environ Med. 2009;20:118-24.

Bechet A, Demet AY, Ozgur S, Murat O, Mehmet U, Selim B. Epidemiological, clinical characteristics and outcome of scorpion envenomation in Batman, Turkey an analysis of 120 cases. J Acad Emerg Med. 2009;8:9-14.

Abdi A, Farshidi H, Rahimi S, Amini A, Tasnim Eftekhari SF. Electrocardiologic and electrocardiographic findings in patients with scorpion sting. Iran Red Crescent Med J. 2013;15:446-7.