Bond G R
Department of Medical Toxicology, Good Samaritan Medical Center, Phoenix, Arizona.
Ann Emerg Med. 1992 Jul;21(7):788-91. doi: 10.1016/s0196-0644(05)81022-4.
To assess the clinical severity of envenomation by the Centruroides scorpion in young children; the potential benefit of antivenin administration with regard to time to resolution of symptoms, prevention of hospitalization, and prevention of invasive intervention; and the risk of acute and delayed hypersensitivity reaction.
Retrospective chart review with follow-up contact.
Referral toxicology management center.
Children less than 10 years of age experiencing severe Centruroides scorpion envenomation.
Administration of goat serum-derived anti-Centruroides antivenin.
Stings in young children may be life threatening, resulting in extreme neuromuscular activity, tachycardia, and respiratory distress. Administration of anti-Centruroides antivenin resulted in rapid resolution of all symptoms without acute reaction in all 12 patients so treated; 58% of patients treated with antivenin had a delayed onset of rash or symptoms of serum sickness.
The benefit of rapid resolution of life-threatening symptoms and potential for outpatient management of severe envenomation in young children may justify the risk of acute and delayed reaction associated with antivenin use in this group. The use of antivenin for the less severe envenomation common in older children and adults may subject them to unjustified risk.
评估幼童被墨西哥毒蝎蜇伤后的临床严重程度；抗蛇毒血清治疗在症状缓解时间、预防住院和预防侵入性干预方面的潜在益处；以及急性和迟发性过敏反应的风险。
采用随访联系的回顾性病历审查。
转诊毒理学管理中心。
10岁以下经历严重墨西哥毒蝎蜇伤的儿童。
给予山羊血清来源的抗墨西哥毒蝎抗蛇毒血清。
幼童被蜇伤可能危及生命，导致极度神经肌肉活动、心动过速和呼吸窘迫。给予抗墨西哥毒蝎抗蛇毒血清后，所有12例接受治疗的患者所有症状均迅速缓解，且无急性反应；58%接受抗蛇毒血清治疗的患者出现皮疹延迟发作或血清病症状。
迅速缓解危及生命症状的益处以及对幼童严重蜇伤进行门诊治疗的可能性，可能证明在该群体中使用抗蛇毒血清相关的急性和迟发性反应风险是合理的。对于年龄较大儿童和成人中常见的不太严重的蜇伤使用抗蛇毒血清，可能会使他们面临不合理的风险。
