Managing scorpion envenomations: A Gabes emergency department case study of 60 patients

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Published Aug 27, 2024
https://doi.org/10.62438/tunismed.v102i9.4885
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Vol. 102 No. 9 (2024): Tunis Med sept 2024

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Amine Hamdaoui
Emergency Department, University Hospital of Gabes, Faculty of Medicine of Sfax, University of Sfax, Tunisia
Houcemeddine Turki
Data Engineering and Semantics Research Unit, Faculty of Medicine of Sfax, University of Sfax, Tunisia
Taha Lassoued
Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
Amal Samet
Emergency Department, University Hospital of Gabes, Faculty of Medicine of Sfax, University of Sfax, Tunisia
Imen Rejeb
Emergency Department, University Hospital of Gabes, Faculty of Medicine of Sfax, University of Sfax, Tunisia

Abstract

Introduction: Scorpion envenomation constitutes a major public health issue in Tunisia, especially in arid regions such as the Gulf of Gabes. It is necessary to understand the epidemiological and clinical characteristics of this condition and the importance of early management.


Aim: This study aims to assess the epidemiological and clinical profile of patients admitted to the emergency department of Gabes University Hospital for scorpion envenomation, as well as the timing of management and intra-hospital evolution.


Methods: A retrospective descriptive study of 60 patients admitted for scorpion envenomation to the Acute Assessement unit at the Emergency Department of the Gabes University Hospital from January 2020 to January 2023.


Results: The average age was 35 years [1-85 years]. A slight male predominance (51.7%) was noted. Patients with chronic somatic diseases accounted for (25%) of our series. The predominant scorpion species was Androctonus australis (71.7%). The majority of incidents occurred during the nighttime (71.7%). Most patients were of rural origin (58.3%). The most common sting sites were the lower limbs (48.8%) and upper limbs (36.7%). Scorpion envenomation stages at admission were: Stage I (3.3%), Stage II (83.3%), and Stage III (8.33%). The average time to management was 2 hours. Patients classified as Stage II at admission or afterward were seen after an average of 3 hours. Patients initially classified as Stage III were seen after an average of 3 hours and 30 minutes, and those classified as Stage III during the hospitalization were seen after an average ..(abstract truncated at 250 words)

Keywords:

Scorpions, Envenomation, Antivenom, Epidemiology, Treatment

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References

  1. Aliane, J., Camus, C., Cariou, A., Cartier, J. C., Castelain, V., Bourenne, J., et al. (2018). Médecine Intensive, réanimation, urgences et défaillances viscérales aiguës: Réussir les ECNi. Paris, France: Elsevier Health Sciences.
  2. Bahloul, M., Kallel, H., Rekik, N., Ben Hamida, C., Chelly, H., & Bouaziz, M. (2005). Atteinte cardiovasculaire lors d’envenimation scorpionique grave: Mécanismes et physiopathologie. La Presse Médicale , 34 (2), 115-120.
  3. Bahloul, M., Regaieg, K., Chabchoub, I., Kammoun, M., Chtara, K., & Bouaziz, M. (2017). Severe scorpion envenomation: pathophysiology and the role of inflammation in multiple organ failure. Médecine et santé tropicales , 27 (2), 214-221.
  4. Ben Othman, A., Ben Abdallah, N., & Ben Aoun, M. (2016). L’envenimation scorpionique au niveau de la région de Faouar-Kebili en 2010–2012: étude de 421 cas. La Tunisie Médicale , 94, 102-106.
  5. Bosnak, M., Ece, A., Yolbas, I., Bosnak, V., Kaplan, M., & Gurkan, F. (2009). Scorpion sting envenomation in children in southeast Turkey. Wilderness & environmental medicine , 20 (2), 118-124.
  6. Bouaziz, M., Bahloul, M., Kallel, H., Samet, M., Ksibi, H., Dammak, H., et al. (2008). Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: multivariate analysis of 951 cases. Toxicon , 52 (8), 918-926.
  7. Boubekeur, K., L’Hadj, M., & Selmane, S. (2020). Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria. Epidemiology and Health , 42, e2020050.
  8. Chakroun-Walha, O., Karray, R., Jerbi, M., Nasri, A., Issaoui, F., Ben Rebeh, A., et al. (2018). Update on the Epidemiology of Scorpion Envenomation in the South of Tunisia. Wilderness & environmental medicine , 29 (1), 29-35.
  9. Chippaux, J. P., & Goyffon, M. (2008). Epidemiology of scorpionism: a global appraisal. Acta tropica , 107 (2), 71-79.
  10. Cupo, P. (2015). Clinical update on scorpion envenoming. Revista da sociedade brasileira de medicina tropical , 48, 642-649.
  11. Darkaoui, B., Lafnoune, A., Chgoury, F., Daoudi, K., Chakir, S., Mounaji, K., et al. (2022). Induced pathophysiological alterations by the venoms of the most dangerous Moroccan scorpions Androctonus mauretanicus and Buthus occitanus: A comparative pathophysiological and toxic-symptoms study. Human & Experimental Toxicology , 41, 09603271211072872.
  12. Frowein, R. A. (1976). Classification of coma. Acta neurochirurgica , 34, 5-10.
  13. Godoy, D. A., Badenes, R., Seifi, S., Salehi, S., & Seifi, A. (2021). Neurological and systemic manifestations of severe scorpion envenomation. Cureus , 13 (4), e14715.
  14. Goyffon, M., Vachon, M., & Broglio, N. (1982). Epidemiological and clinical characteristics of the scorpion envenomation in Tunisia. Toxicon , 20 (1), 337-344.
  15. Hamouda, C., & Ben Salah, N. (2010). Envenimations scorpioniques en Tunisie. Mediterranean Journal of Emergency Medicine , 5, 24-32.
  16. Heidarpour, M., Ennaifer, E., Ahari, H., Srairi-Abid, N., Borchani, L., Khalili, G., et al. (2012). Histopathological changes induced by Hemiscorpius lepturus scorpion venom in mice. Toxicon , 59 (3), 373-378.
  17. Khattabi, A., Soulaymani-Bencheikh, R., Achour, S., & Salmi, L. R. (2011). Classification of clinical consequences of scorpion stings: consensus development. Transactions of the Royal Society of Tropical Medicine and Hygiene , 105 (7), 364-369.
  18. Meki, A. R., Mohamed, Z. M., & Mohey El-deen, H. M. (2003). Significance of assessment of serum cardiac troponin I and interleukin-8 in scorpion envenomed children. Toxicon , 41 (2), 129-137.
  19. Petricevich, V. L. (2010). Scorpion venom and the inflammatory response. Mediators of inflammation , 2010, 903295.
  20. Santos, M. S., Silva, C. G., Neto, B. S., Grangeiro Junior, C. R., Lopes, V. H., Teixeira Junior, A. G., et al. (2016). Clinical and epidemiological aspects of scorpionism in the world: a systematic review. Wilderness & Environmental Medicine , 27 (4), 504-518.
  21. Sneyd, J. R., Absalom, A. R., Barends, C. R., & Jones, J. B. (2022). Hypotension during propofol sedation for colonoscopy: a retrospective exploratory analysis and meta-analysis. British Journal of Anaesthesia , 128 (4), 610-622.