Coelho Johne Souza, Ishikawa Edna Aoba Yassui, Dos Santos Paulo Roberto Silva Garcez, Pardal Pedro Pereira de Oliveira
Postgraduate Program in Tropical Diseases, Center of Tropical Medicine, Federal University of Pará (UFPA), Belém, PA Brazil ; Laboratory of Medical Entomology and Venomous Animals, Center of Tropical Medicine, Federal University of Pará (UFPA), Av. Generalíssimo Deodoro, 92, Umarizal, Belém, 66055-240 Pará Brazil.
Laboratory of Medical Entomology and Venomous Animals, Center of Tropical Medicine, Federal University of Pará (UFPA), Av. Generalíssimo Deodoro, 92, Umarizal, Belém, 66055-240 Pará Brazil.
J Venom Anim Toxins Incl Trop Dis. 2016 Aug 26;22(1):24. doi: 10.1186/s40409-016-0079-2. eCollection 2016.
Scorpionism is a serious public health problem in Brazil. Although cases of envenomation by scorpions are frequent in Brazil, Tityus silvestris - found throughout the Amazon region - is considered of minor medical significance and with only a few descriptions in the literature. This article aims to describe for the first time the epidemiological characteristics and clinical manifestations of scorpion stings by T. silvestris that occurred in eastern Brazilian Amazon.
A prospective and observational study was carried out on 13 confirmed cases of T. silvestris envenomation registered from 2007 to 2011 in the cities of Belém and Ananindeua, Pará state, Brazil.
The stings occurred mainly during daytime, at domiciliary environment, and the scorpions were found in clothing, fruits or vegetables. Envenomation was more frequent in the age group between 21 and 30 years old, upper limbs were more affected and medical aid was usually provided within two hours. Men and women were equally affected. Regarding severity, ten patients were classified as Class I and three patients as Class II according to the Scorpion Consensus Expert Group. Local manifestations were present in all patients, being pain the most common symptom. Mild systemic manifestations including nausea, vomiting, somnolence, malaise and prostration were observed in three victims. Symptomatic treatment of pain was offered to all patients, and only one received specific antivenom. All victims had a favorable outcome.
To the best of our knowledge, this study is the first to report the systemic symptomatology of envenomation by T. silvestris in the Brazilian Amazon, highlighting the medical relevance of the species in this region. Further research on the venom and clinical manifestations of envenomation by T. silvestris should be conducted in order to verify the relevance of this species to public health.
蝎蜇伤在巴西是一个严重的公共卫生问题。尽管在巴西蝎子蜇伤的病例很常见，但在整个亚马逊地区发现的西尔维斯特肥尾蝎被认为医学意义不大，且文献中仅有少数描述。本文旨在首次描述巴西亚马逊东部地区发生的西尔维斯特肥尾蝎蜇伤的流行病学特征和临床表现。
对2007年至2011年在巴西帕拉州贝伦和阿纳尼德乌市登记的13例确诊的西尔维斯特肥尾蝎蜇伤病例进行了一项前瞻性观察研究。
蜇伤主要发生在白天，在家居环境中，蝎子出现在衣物、水果或蔬菜上。21至30岁年龄组的蜇伤更为频繁，上肢受影响更大，通常在两小时内提供医疗救助。男性和女性受影响程度相同。根据蝎蜇伤共识专家组的分类，10例患者被归类为I级，3例患者被归类为II级。所有患者均有局部表现，疼痛是最常见的症状。3名受害者出现了包括恶心、呕吐、嗜睡、不适和虚脱在内的轻度全身表现。所有患者均接受了疼痛的对症治疗，只有1例接受了特异性抗蛇毒血清治疗。所有受害者均预后良好。
据我们所知，本研究首次报告了巴西亚马逊地区西尔维斯特肥尾蝎蜇伤的全身症状，突出了该物种在该地区的医学相关性。应进一步研究西尔维斯特肥尾蝎的毒液和蜇伤的临床表现，以验证该物种对公共卫生的相关性。
