[Escorpionism in pediatric intensive care patients. Case series]

Arch Argent Pediatr. 2019 Aug 1;117(4):e368-e372. doi: 10.5546/aap.2019.e368.
[Article in Spanish]

Abstract

Scorpionism is a public health problem with an increasing incidence in Argentina. The poison contains several neurotoxins capable of generating an "autonomic storm" responsible for the clinical manifestations. The cardiovascular and respiratory systems are the most affected ones and their degree of commitment will determine morbidity and mortality. A 10 % of cases in children evolve to their severe form. In this retrospective series, we describe the epidemiology and evolution of 17 patients admitted to the Pediatric Intensive Care Unit from January 2010 to January 2014. Although there was no mortality, there was a high morbidity: 12 patients had acute lung edema requiring mechanical ventilation, 11 patients developed hypotensive cardiogenic shock, 7 were under severe low cardiac output and in 6 levosimendan was used due to the low refractory output.

El escorpionismo constituye un problema de salud pública con una incidencia en aumento en Argentina. El veneno contiene varias neurotoxinas capaces de generar una "tormenta autonómica" responsable de las manifestaciones clínicas. Los sistemas cardiovascular y respiratorio son los más afectados y su grado de compromiso determinará la morbimortalidad. Un 10 % de los casos en niños evolucionan a su forma grave. En esta serie retrospectiva, se describe la epidemiología y evolución de 17 pacientes ingresados a la Unidad de Terapia Intensiva Pediátrica entre enero de 2010 y enero de 2014. Si bien no hubo mortalidad, sí una alta morbilidad: 12 pacientes presentaron edema agudo de pulmón que requirió ventilación mecánica; 11 pacientes desarrollaron shock cardiogénico hipotensivo; 7, bajo gasto cardíaco grave y, en 6, se utilizó levosimendán por el carácter refractario de su bajo gasto.

Keywords: Critical care; Pediatrics; Scorpion stings; Shock.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Intensive Care Units, Pediatric
  • Male
  • Retrospective Studies
  • Scorpion Stings* / complications
  • Scorpion Stings* / diagnosis
  • Scorpion Stings* / epidemiology
  • Scorpion Stings* / therapy