亚利桑那州的蝎子螫伤与抗蛇毒血清应用。

Scorpion Stings and Antivenom Use in Arizona.

机构信息

Division of Infectious Diseases, Department of Medicine.

出版信息

Am J Med. 2021 Aug;134(8):1034-1038. doi: 10.1016/j.amjmed.2021.01.025. Epub 2021 Feb 22.

DOI:10.1016/j.amjmed.2021.01.025

PMID:33631163

Abstract

BACKGROUND

Arizona's rugged desert landscape harbors many venomous animals, including a small nocturnal scorpion, Centruroides sculpturatus, whose venom can cause severe neuromotor disturbance. An effective antivenom is available at selected health care facilities in the state.

METHODS

We analyzed 4398 calls of scorpion stings to the Arizona Poison and Drug Information Center (APDIC) in Tucson over a period of 3 years, from January 2017 to December 2019.

RESULTS

We followed 1952 (44.4%) of the victims to resolution. We excluded 2253 callers with minimal effects of the sting and 193 victims with possible toxic effects who were lost to follow-up. The most common complaints among callers were pain at the sting site in 88.9% and local numbness in 62.2%. Detailed clinical information was obtained from 593 calls from a health care facility. Neuromotor signs consistent with C. sculpuratus envenomation included nystagmus in 163 (27.5%), hypersalivation in 91 (15.3%), and fasciculations in 88 (14.8%). Antivenom (Anascorp; Rare Disease Therapeutics, Inc., Franklin, Tenn) was administered to 145 patients. Most were children <5 years old (n = 76, or 54.4%); 27 (18.6%) were 5-9 years old and 42 (30.0%) were ≥10 years of age. About half, 79 of 145 (54.5%) victims who received antivenom, met the APDIC recommended use criteria.

CONCLUSIONS

Patients treated with antivenom exhibited a rapid resolution of symptoms without immediate or delayed hypersensitivity reactions. We recommend broadened availability of antivenom at sites where it is most needed.

摘要

背景

亚利桑那州崎岖的沙漠地貌栖息着许多有毒动物，包括一种小型夜间蝎子 Centruroides sculpturatus，其毒液可导致严重的神经运动障碍。在该州的一些医疗机构可以获得有效的抗蛇毒血清。

方法

我们分析了 2017 年 1 月至 2019 年 12 月期间图森市亚利桑那毒物和药物信息中心（APDIC）接到的 4398 例蝎子蜇伤电话。

结果

我们对 1952 例（44.4%）患者进行了随访直至痊愈。我们排除了 2253 例蜇伤症状轻微的来电者和 193 例可能有毒性影响但失访的受害者。来电者最常见的投诉是蜇伤部位疼痛（88.9%）和局部麻木（62.2%）。从一家医疗机构的 593 个电话中获得了详细的临床信息。与 C. sculpuratus 中毒一致的神经运动体征包括眼球震颤（163 例，27.5%）、流涎过多（91 例，15.3%）和肌束震颤（88 例，14.8%）。抗蛇毒血清（Anascorp；Rare Disease Therapeutics，Inc.，Franklin，Tenn）给 145 名患者使用。大多数是<5 岁的儿童（n=76，54.4%）；27 名（18.6%）为 5-9 岁，42 名（30.0%）为≥10 岁。大约一半（145 例中有 79 例，54.5%）接受抗蛇毒血清治疗的患者符合 APDIC 推荐的使用标准。