Investigation of clinical and paraclinical manifestations of envenomation victims referred to the Poisoning Department of Imam Reza Hospital, Mashhad (Iran) from 2019 to 2020

Bites and stings from venomous animals are a global phenomenon. The types of envenomation inflicted by these animals include those from snakes, scorpions, spiders, and bees, particularly in tropical regions. Due to the rise in reported snakebite cases, as reported by the World Health Organization, and the pivotal role of prompt antivenom administration in reducing complications and improving outcomes, there is a pressing need for further investigation in this area. This study was conducted to elucidate the clinical and paraclinical manifestations experienced by victims. All hospitalized victims from April 2019 to May 2020 due to bites and stings from poisonous animals were examined in the Poisoning Department of Imam Reza Hospital at Mashhad. Demographic, clinical, and paraclinical information were recorded using a checklist prepared for all patients. Finally, the obtained data were statistically analyzed by SPSS statistical software. This study included 146 patients (mean age 32 years; 79% male), including 62 snake bites (42.5%), 49 scorpion stings (33.6%), and 35 spider bites (24%). Pain was the predominant local symptom at admission (96.8% snake, 98% scorpion, and 85.7% spider), followed by swelling (85.5% snake, 40.8% scorpion, and 48.6 % spider) and erythema, which was most common in spider bites (45.7%). The leading systemic manifestations were generalized weakness (37%), vomiting (32.9%), and radicular pain (14.4%). Exposures occurred significantly more often at home (69.2%), particularly in suburban areas of Mashhad (p = 0.046). The lower limb was the most frequent site of envenomation (45.2%). At discharge, pain persisted in 37% of patients. Vital signs and laboratory findings were mostly normal, except for increased CPK values. Imaging revealed deep vein thrombosis (DVT) in three cases with snakebite. During 2019-2020 in Mashhad, envenomation cases were mainly attributable to snake bites and scorpion stings, presenting with local pain, swelling, and general weakness. Frequent home exposures and lower limb involvement underscore the importance of focused preventive strategies. While most patients recovered without major complications, some required surgical interventions, intensive care unit (ICU) admission, and even cardiopulmonary resuscitation (CPR), highlighting the critical role of early intervention and consistent follow‑up.