a Department of Medical Toxicology , Banner - University Medical Center Phoenix , Phoenix , AZ , USA.
b Center for Toxicology and Pharmacology Education and Research , University of Arizona College of Medicine - Phoenix , Phoenix , AZ , USA.
Clin Toxicol (Phila). 2018 Mar;56(3):170-174. doi: 10.1080/15563650.2017.1353095. Epub 2017 Jul 28.
The preponderance of medical literature regarding severe bark scorpion envenomation describes pediatric patients; however, the majority (>66%) of annual poison center calls pertain to adults. This retrospective review sought to evaluate the clinical manifestations of adults with severe Centruroides sculpturatus envenomation and determine if significant morbidity occurred.
This is a retrospective review of adults presenting to a single tertiary referral center with Grade-III or Grade-IV scorpion envenomation from 1 January 2007 to 3 March 2013. The primary objective is to describe clinical findings, treatment strategies, complications and short-term outcomes.
Thirty-three patients were included; 61% were female (20/33), average age was 40.7 (19-81) years. The average time to healthcare facility was 142 (14-720) minutes. The most common signs and symptoms of envenomation were: pain/paresthesias 94%, opsoclonus 82%, excessive motor activity 76%, visual disturbance 76%. Benzodiazepines 85% (29/33) and opioids 83% (28/33) were the most frequently used agents to control envenomation. Cardiac evaluation was performed in 24% of patients, 6% were pregnant and underwent fetal monitoring, 6% were intubated and 3% developed rhabdomyolysis. Average length of stay (LOS) was 28.3 (1.5-307) hours; 58% (19/33) required hospital admission. Four patients had LOS >48 h, with pre-existing cardiac disease, substance misuse disorder, acute ethanol withdrawal and medical errors identified as factors contributing to prolonged LOS.
Bark scorpion envenomation in adults may be severe, necessitating medical intervention and hospital admission. Comorbid conditions and complications arising from treatment may contribute to prolonged LOS.
大多数关于严重树皮蝎子螫伤的医学文献都描述了儿科患者；然而，每年中毒中心接到的电话中，有超过 66%（>66%）是成年人打来的。这项回顾性研究旨在评估严重 Centruroides sculpturatus 螫伤的成年患者的临床表现，并确定是否发生严重的发病率。
这是对 2007 年 1 月 1 日至 2013 年 3 月 3 日期间因三级或四级蝎子螫伤到一家三级转诊中心就诊的成年人进行的回顾性研究。主要目的是描述临床发现、治疗策略、并发症和短期结果。
共纳入 33 例患者；61%（20/33）为女性，平均年龄为 40.7（19-81）岁。平均到达医疗机构的时间为 142（14-720）分钟。最常见的螫伤体征和症状为：疼痛/感觉异常 94%（31/33），眼球震颤 82%（28/33），过度运动活动 76%（24/33），视力障碍 76%（24/33）。苯二氮䓬类药物 85%（29/33）和阿片类药物 83%（28/33）是最常用于控制螫伤的药物。24%的患者进行了心脏评估，6%的孕妇接受了胎儿监测，6%的患者进行了气管插管，3%的患者发生了横纹肌溶解症。平均住院时间（LOS）为 28.3（1.5-307）小时；58%（19/33）需要住院治疗。4 例患者的 LOS>48 h，原因是存在先前存在的心脏病、物质使用障碍、急性乙醇戒断和医疗失误，这些因素导致 LOS 延长。
成年人的树皮蝎子螫伤可能很严重，需要医疗干预和住院治疗。合并症和治疗引起的并发症可能导致 LOS 延长。
