Asymmetric pulmonary edema after scorpion sting: a case report

Abstract

SUMMaRYA 12-year-old boy was referred with acute asymmetric pulmonary edema (APE) four-hour after scorpion sting to Emergency department. On admission, the main clinical manifestations were: dyspnea, tachypnea, and tachycardia. Chest x-ray revealed APE predominantly on the right hemithorax. The patient was treated with oxygen, intravenous frusemide and digoxin and discharged on the sixth hospital day in a good condition. This case report emphasizes the occurrence of asymmetric pulmonary edema after severe scorpion envenomation within few hours immediately after the sting.

Epidemiological, Clinical Characteristics and Outcomes of Scorpion Sting in Southeastern Region of Turkey

“…There was a significant difference between SS incidents in terms of place of residence (p<0.005). The patients admitted to the emergency service in a mean of 4.3±3.5 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) hours after the trauma. The majority of the victims were stung by scorpions while they were at active work (42.3%) or asleep (19.5%) in bed.…”

“…[4] Mortality due to SSs is associated with cardiac dysfunction and pulmonary edema. [5] The clinical picture depends on the anatomical location of the sting and the victim's age, weight and health status. [2,6] Although SSs are more common in adults and males, mortality is higher in children.…”

Scorpion bite-induced unilateral pulmonary oedema

“…Both sympathetic and parasympathetic postganglionic stimulation is the proposed mechanism of action of scorpion venom. However, in most circumstances, the sympathetic response predominates, leading to a ‘sympathetic storm’ 3. Stimulation of alpha receptors by the scorpion toxins is responsible for the cool extremities, arterial hypertension, myocardial dysfunction, tachycardia and pulmonary oedema.…”

A case report: Myocarditis and pulmonary edema after scorpion sting

“…Akrep sokmaları sonrası görülebilen miyokardite bağlı gelişen, kalp yetmezliği ve pulmoner ödem gibi ağır klinik tablolarda sıvı tedavisi, alfa blokerler, inotrop tedavi ve sıkı yoğun bakım takipleri ile mortalite ve morbidite azaltılmaktadır. Alfa blokerlerin özellikle akut dönemde görülen katekolamin fırtınasını bastırarak etki ettikleri düşünülmektedir (17) .…”