Román Juan P, García Fernanda, Medina Doris, Vásquez Manolo, García José, Graham Matthew R, Romero-Alvarez Daniel, Pardal Pedro P de Oliveira, Ishikawa Edna A Y, Borges Adolfo
Hospital General de Macas, Macas, Morona Santiago, Ecuador.
Department of Biology, Eastern Connecticut State University, 83 Windham St., Willimantic, CT 06226, USA.
Acta Trop. 2018 Feb;178:1-9. doi: 10.1016/j.actatropica.2017.10.014. Epub 2017 Oct 25.
Scorpion envenoming by species in the genus Tityus is hereby reported from rural locations in the Amazonian province of Morona Santiago, southeastern Ecuador. Twenty envenoming cases (18 patients under 15 years of age) including one death (a 4-year-old male) were recorded at the Macas General Hospital, Morona Santiago, between January 2015 and December 2016 from the counties of Taisha (n=17), Huamboyo (n=1), Palora (n=1), and Logroño (n=1). An additional fatality from 2014 (a 3-year-old female from Nayantza, Taisha county) is also reported. Leukocytosis and low serum potassium levels were detected in most patients. We observed a significant negative correlation between leukocytosis and hypokalemia. Scorpions involved in three accidents from Macuma, Taisha County, were identified as genetically related to Tityus obscurus from the Brazilian Amazonian region based on comparison of mitochondrial DNA sequences encoding cytochrome oxidase subunit I. These cases, along with previously reported envenoming from northern Manabí, reinforce the notion that scorpionism is a health hazard for children in Ecuador and emphasizes the need to supply effective antivenoms against local species, which are not currently available. The genetic affinity of the Ecuadorian specimens with T. obscurus may underlay toxinological, clinical, and venom antigenic relationships among Amazonian scorpions that deserves further exploration for designing therapeutic strategies to treat scorpionism in the region.
据报告，在厄瓜多尔东南部莫罗纳 - 圣地亚哥省的亚马逊地区农村，出现了被蒂尤斯属蝎子蜇伤的情况。2015年1月至2016年12月期间，在莫罗纳 - 圣地亚哥省的马卡斯综合医院记录了20起蜇伤病例（18名15岁以下患者），其中包括1例死亡（一名4岁男性），这些病例分别来自泰沙县（n = 17）、万博约县（n = 1）、帕洛拉县（n = 1）和洛格罗尼奥县（n = 1）。还报告了2014年的另一起死亡病例（一名来自泰沙县纳扬察的3岁女性）。大多数患者检测到白细胞增多和血清钾水平降低。我们观察到白细胞增多与低钾血症之间存在显著的负相关。根据编码细胞色素氧化酶亚基I的线粒体DNA序列比较，参与泰沙县马库马三起事故的蝎子被确定与巴西亚马逊地区的暗黑蒂尤斯在基因上相关。这些病例，连同之前报告的马纳比北部的蜇伤事件，强化了蝎子蜇伤对厄瓜多尔儿童构成健康危害的观念，并强调需要提供针对当地物种的有效抗蛇毒血清，而目前尚无此类血清。厄瓜多尔标本与暗黑蒂尤斯的基因亲和力可能是亚马逊蝎子之间毒理学、临床和毒液抗原关系的基础，这值得进一步探索，以便设计该地区治疗蝎子蜇伤的治疗策略。
