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儿童疑似被蝎子蛰伤后发生缺血性脑卒中。

Ischemic Stroke in a Child after a Probable Scorpion Sting.

机构信息

Policlínica Metropolitana, Caracas, Venezuela.

Tecnológico de Monterrey, Ciencias de la Salud y Escuela de Medicina, Guadalajara, Mexico.

出版信息

Am J Trop Med Hyg. 2021 Nov 29;106(3):959-961. doi: 10.4269/ajtmh.21-0880.

Abstract

Scorpion stings are common emergencies in the tropics. Species-specific antivenom therapies are available. However, fatalities resulting from scorpion stings remain a public health concern in many settings. Children residing in rural towns and peri-urban areas represent the most vulnerable populations. Delays in the diagnosis of scorpion stings often occur as a result of the non-specific clinical presentations, which then lead to life-threatening complications. We report a 2-year-old Venezuelan boy presenting with acute pancreatitis and pulmonary edema without an identifiable cause 48 hours after his initial symptoms. We administered antivenom therapy when an undetected scorpion sting was suspected. Despite some initial clinical improvement with respect to his acute pancreatitis, pulmonary edema, and coagulation abnormalities, our patient experienced an ischemic stroke. Fortunately, our patient did demonstrate some neurological improvement. Although acute pancreatitis and pulmonary edema are known end-organ damage manifestations of the sting of Tityus in the Americas, our particular case illustrates the risk of ischemic stroke.

摘要

蝎蜇在热带地区很常见。有针对特定物种的抗蛇毒血清疗法。然而,在许多情况下,蝎蜇导致的死亡仍然是一个公共卫生关注点。居住在农村城镇和城郊地区的儿童是最脆弱的人群。由于非特异性的临床表现,蝎蜇的诊断常常会出现延迟,这进而导致危及生命的并发症。我们报告了一名 2 岁的委内瑞拉男孩,在最初症状出现 48 小时后,出现急性胰腺炎和肺水肿,但无明确病因。当怀疑有未被发现的蝎蜇时,我们给予了抗蛇毒血清治疗。尽管他的急性胰腺炎、肺水肿和凝血异常的最初临床状况有所改善,但我们的患者出现了缺血性中风。幸运的是,我们的患者的神经系统确实有所改善。尽管急性胰腺炎和肺水肿是美洲 Tityus 蜇伤的已知终末器官损害表现,但我们的特殊病例说明了发生缺血性中风的风险。

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本文引用的文献

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Effects of Brazilian scorpion venoms on the central nervous system.巴西蝎子毒液对中枢神经系统的影响。
J Venom Anim Toxins Incl Trop Dis. 2018 Jan 23;24:3. doi: 10.1186/s40409-018-0139-x. eCollection 2018.
3
Epidemiological and clinical study on scorpionism in French Guiana.法属圭亚那蝎螫的流行病学和临床研究。
Toxicon. 2013 Oct;73:56-62. doi: 10.1016/j.toxicon.2013.05.025. Epub 2013 Jun 19.

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