Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. (2019)

• Record Type: Journal Article
• Authors: Abd El-Aziz, Fatma El-Zahraa A.; El Shehaby, Doaa M.; Elghazally, Shimaa A.; Hetta, Helal F.
• Is Part Of: Toxicology reports. Volume 6(2019)
• Page Start: 329
• Page End: 335
• Publication Date: 2019
• Subjects: ECG electrocardiography -- GCS Glasgow coma scale -- SEM scanning electron microscopy -- TAS time after sting -- BCSS basitarsal compound slit sensilla; Scorpion -- Envenomation -- Toxicological -- Leiurus quinquestriatus -- Androctonus crassicauda -- Scanning electron microscopy -- Luxor -- Egypt; Toxicology -- Periodicals; Clinical toxicology -- Periodicals; Drug-Related Side Effects and Adverse Reactions; Hazardous Substances; Poisoning; Toxicology; Electronic journals; Periodicals; Periodicals; 571.9505
• DOI: 10.1016/j.toxrep.2019.03.004
• Languages: English
• ISSNs: 2214-7500

Abstract

Graphical abstract: Highlights: Scorpion sting is still a threatening heath problem in developing countries as Egypt. Scorpion stings are common among children. Local reactions to scorpion stings were; pain at sting site was most frequent followed by redness and swelling. Systemic manifestations of were vomiting, headache, disturbed conscious level and abnormalities in ECG. Cardiac dysrhythmia was the main cause of death. Manifestations due to Leiurus quinquestriatus envenamation are more severe than that due to Androctonus crassicauda, while latent onset of manifestations in Androctonus crassicauda cases responsible for bad prognosis and high mortality. Abstract: Background and aim: Scorpion envenomation is a common acute life threatening health problem in developing countries as Egypt. Scorpion venom is a complex structure composed of neurotoxic proteins, salts, acidic proteins, and organic compounds, thereby having of neurologic, cardiovascular, hematologic, and renal side effects, in addition to local effects such as redness, pain, burning, and swelling. Aims: The study consisted of two parts to describe demographic characteristics, toxicological manifestations of scorpion sting cases in Luxor, Egypt and morphological characterization of the commonest scorpion species in the studied community for easy rapid identification of scorpion species by doctors from the patient history to provide better choices of management Materials & methods: First part of the study include all cases of scorpion envenomation attending General Hospital of Esna, Luxor, Egypt during the period of scorpion activity 2017, demographic data was collected then cases were assessed for clinical manifestations, ECG, complications and deaths related to scorpion species. Second part: scorpions were collected from areas around patient housing for morphological description of their sense organs and venom apparatus by Scanning Electron Microscopy. Results: A total of 110 cases of scorpion stings were reviewed, males 81 (72.9%) and females 30 (27.1%), with a mean age of 31.9 ± 17.9 years. Localized pain was the most frequent presenting complaint (89 80.2%), vomiting was the commonest clinical symptom (90.9%). All scorpion stings were due to the most endemic species in North Africa, Leiurusquinquestriatus & Androctonuscrassicauda. Death rate among cases was (5.5%) all were Abroug's Grade III. Cardiac dysrhythmia and subsequent pulmonary edema were the commonest cause of death. Clinical manifestations were more sever in Leiurus quinquestriatus stings while death rate was more in Androctonus crassicauda stings. The morphological characterization of the sense organs (eyes, pedipalps, pectines& sensory setae) and venom apparatus of the scorpions L. quinquestriatus & A. crassicauda were described by Scanning Electron Microscopy. Conclusion: Scorpion sting is an acute heath threating in Southern Egypt, Leiurus quinquestriatus & Androctonus crassicauda are most endemic scorpion species in Southern Egypt. More attention for scorpion envenomation in such subtropical hyper desert localities is required to eradicate toxic scorpion species and prevent possible causes of deaths.