Scorpion sting: a review of 121 cases

Scorpion sting is a hazardous and potentially lethal condition. One hundred twenty-one scorpion sting patients were admitted to hospitals in Mahad Maharashtra state, India, during 1986–89. Sixty-six (54.5%) victims had hypertension (mean blood pressure 96 to 160 [average 118.6] mmHg). Twenty-four (19.5%) victims demonstrated tachycardia, with heart rates ranging from 110 to 215 (average 156) beats per minute. Twenty-two (18.8%) had pulmonary edema, while nine (8.5%) died. Analysis of our data suggests that cardiovascular morbidity and mortality depends upon the time between the stings and hospitalization or administration of vasodilators. Current management of scorpion envenomation consists of rapid reduction of hypertension with sublingual nifedipine, postsynaptic alpha adrenergic blockade with prazosin hydrochloride, and digoxin therapy for myocardial failure. Massive pulmonary edema can be treated with sodium nitroprusside. In our setting, mortality is reduced by early hospitalization, even though specific antivenin is not available in India.