Severe scorpion envenomation in Brazil: clinical, laboratory and anatomopathological aspects Escorpionismo grave no Brasil: aspectos clínicos, laboratoriais e anatomopatológicos

Scorpion stings in Brazil are important not only because of their incidence but also for their potential ability to induce severe, and often fatal, clinical situations, especially among children. In this report we present the clinical and laboratory data of 4 patients victims of scorpion stings by T...

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Bibliographic Details
Published in:Revista do Instituto de Medicina Tropical de São Paulo
Main Authors: Palmira Cupo, Mauro Jurca, Marisa M. Azevedo-Marques, João Samuel M. Oliveira, Sylvia E. Hering
Format: Article in Journal/Newspaper
Language:English
Published: Universidade de São Paulo (USP) 1994
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Online Access:https://doi.org/10.1590/S0036-46651994000100011
https://doaj.org/article/358835a8443641848cc642f552035bc7
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Summary:Scorpion stings in Brazil are important not only because of their incidence but also for their potential ability to induce severe, and often fatal, clinical situations, especially among children. In this report we present the clinical and laboratory data of 4 patients victims of scorpion stings by T. serrulatus, who developed heart failure and pulmonary edema, with 3 of them dying within 24 hours of the sting. Anatomopathologic study of these patients revealed diffuse areas of myocardiocytolysis in addition to pulmonary edema. The surviving child presented enzymatic, electrocardiographic and echocardiographic changes compatible with severe cardiac involvement, which were reversed within 5 days. These findings reinforce the need for continuous monitoring of patients with severe scorpion envenoming during the hours immediately following the sting. Os acidentes escorpiônicos no Brasil, assumem grande importancia não só pela sua incidência como pela sua potencialidade em induzir quadros clínicos graves, muitas vezes fatais, principalmente em crianças. Apresentamos neste relato os dados clínicos e laboratoriais de 4 pacientes vítimas de escorpionismo, causado pelo T. serrulatus, que evoluíram com falência cardíaca e edema pulmonar, sendo que 3 foram a óbito dentro das primeiras 24 horas após acidente. O estudo anátomopatológico desses pacientes revelou áreas de miocardiocitólise, além do edema pulmonar. Na criança que sobreviveu foram detectadas alterações enzimáticas, eletro e ecocardiográficas compatíveis com grave comprometimento cardíaco, reversíveis dentro de 5 dias. Tais achados reafirmam a necessidade de monitorização contínua no paciente com escorpionismo grave, nas horas subsequentes ao envenenamento.