Epidemiology, clinical presentation and final outcome of patients with scorpion bite

Most of the scorpion sting cases are acute life-threatening and time-limiting medical emergencies. The present study was undertaken to analyze the varied clinical presentations in patients admitted with a history of scorpion bite, with a special emphasis to find out whether any difference existed in the presentation of paediatric patients in comparison to the adult patients and to understand whether any particular signs and symptoms were associated with increased mortality and morbidity in different age groups. Also, the final outcomes in all the age groups were noted. This study was conducted at a tertiary care hospital (SRN Hospital, Allahabad) from April 2006 to September 2007. In all the age groups, 74 cases presenting with a history of scorpion sting were either observed or admitted to the intensive coronary care unit (ICCU). They were classified into different groups (A-D) depending upon the clinical presentation. GROUP A included patients who presented only with local signs or those who were asymptomatic; GROUP B included patients having signs of acute pulmonary oedema (APO); GROUP C included patients with signs of APO and myocarditis and GROUP D included patients with APO, myocarditis and encephalopathy or encephalopathy alone. The final outcome was tabulated and the results were analyzed to associate the mortality with any particular clinical parameter. The treatment protocol was designed according to the groups divided. The older age group (5-15 years) comprised of the asymptomatic group (Group-A) in which survival was excellent (100%). Group B comprised of the maximum number of patients ie.52 (70.27%). In this group, the patients in the age group of 5-15 years were the largest cohort. Survival in this group was quite satisfactory, with a recovery rate of 96.16%. Group C patients had an additional element of myocarditis which affected the younger individuals i.e. age groups less than 5 and 5-15 years comprising of 3 patients each. In this group, mortality was seen in 2 (33.33%) patients. Group D had the worst outcome with 100% mortality rates and affected the extremes in the age groups from very young (less than 5 years) to the elderly (above 15 years) patients. An incidental finding of priapism was noted in 27.02% of the patients. The point to be noted was that it was present in 100% of the cases in the age group of less than 5 years in male children and in 40 % of the cases in the age group of 5-15 years in males. There was no incidence of priapism in males above 15 years.