Scorpion Stings and Antivenom Use in Arizona

Stephen A. Klotz, Sarah Yates, Shannon L. Smith, Steven Dudley, Justin O. Schmidt, F. Mazda Shirazi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Arizona's rugged desert landscape harbors many venomous animals, including a small nocturnal scorpion, Centruroides sculpturatus, whose venom can cause severe neuromotor disturbance. An effective antivenom is available at selected health care facilities in the state. Methods: We analyzed 4398 calls of scorpion stings to the Arizona Poison and Drug Information Center (APDIC) in Tucson over a period of 3 years, from January 2017 to December 2019. Results: We followed 1952 (44.4%) of the victims to resolution. We excluded 2253 callers with minimal effects of the sting and 193 victims with possible toxic effects who were lost to follow-up. The most common complaints among callers were pain at the sting site in 88.9% and local numbness in 62.2%. Detailed clinical information was obtained from 593 calls from a health care facility. Neuromotor signs consistent with C. sculpuratus envenomation included nystagmus in 163 (27.5%), hypersalivation in 91 (15.3%), and fasciculations in 88 (14.8%). Antivenom (Anascorp; Rare Disease Therapeutics, Inc., Franklin, Tenn) was administered to 145 patients. Most were children <5 years old (n = 76, or 54.4%); 27 (18.6%) were 5-9 years old and 42 (30.0%) were ≥10 years of age. About half, 79 of 145 (54.5%) victims who received antivenom, met the APDIC recommended use criteria. Conclusions: Patients treated with antivenom exhibited a rapid resolution of symptoms without immediate or delayed hypersensitivity reactions. We recommend broadened availability of antivenom at sites where it is most needed.

Original languageEnglish (US)
Pages (from-to)1034-1038
Number of pages5
JournalAmerican Journal of Medicine
Volume134
Issue number8
DOIs
StatePublished - Aug 2021
Externally publishedYes

Keywords

  • Antivenom
  • Bark scorpion
  • Centruroides sculpturatus
  • Fasciculations
  • Hypersalivation
  • Rotary nystagmus
  • Scorpion stings

ASJC Scopus subject areas

  • Medicine(all)

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