Banait Shashank, Thakre Krupali, Banait Tanvi, Jain Jyoti, Patode Manish
Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.
Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Dec 14;14(12):e32536. doi: 10.7759/cureus.32536. eCollection 2022 Dec.
Scorpion stings are painful but harmless and are rarely life-threatening. There is emerging evidence of the association of electrocardiographic (ECG) changes in patients following scorpion stings. We report a case of scorpion sting in a patient in central rural India and provide a review of similar published cases. A 55-year-old previously healthy female was hospitalized in the department of medicine at our institute within two hours of a scorpion sting. She presented with severe pain at the site of the sting and profuse sweating. Her routine investigations (complete blood count renal function test, liver function tests, and arterial blood gas analysis) results were normal. Her electrocardiogram revealed acute myocardial infarction, and serial ECG showed ST and T-wave changes. On laboratory investigation, it was found that her troponin-T was positive and creatinine phosphokinase levels were raised. There was apical wall hypokinesia on transthoracic echocardiography on Day 1 and Day 2. The patient recovered completely and was discharged within five days of hospitalization once her symptoms improved. This case highlights the severe presentation of scorpion stings in otherwise healthy females. The chances of improved clinical symptoms are more if prazosin (125-250 ug) is administered early after scorpion-stung patients experience cardiac abnormalities. This treatment can dramatically alter scorpion envenomation's morbidity and mortality depending on the duration after which it is administered. This case raised our interest due to cardiovascular manifestations in the patient and the early treatment with prazosin for the scorpion sting. Hence, this case was reported for the purpose of creating awareness among physicians and protecting the more vulnerable population.
蝎子蜇伤虽会引起疼痛,但通常无害,很少危及生命。越来越多的证据表明,蝎子蜇伤患者会出现心电图(ECG)变化。我们报告了一例印度中部农村地区患者的蝎子蜇伤病例,并对已发表的类似病例进行了综述。一名55岁、此前健康的女性在被蝎子蜇伤后两小时内被收治于我院内科。她蜇伤部位剧痛且大汗淋漓。其常规检查(全血细胞计数、肾功能检查、肝功能检查和动脉血气分析)结果均正常。她的心电图显示急性心肌梗死,系列心电图显示ST段和T波改变。实验室检查发现她的肌钙蛋白T呈阳性,肌酸磷酸激酶水平升高。第1天和第2天经胸超声心动图显示心尖壁运动减弱。患者完全康复,症状改善后在住院五天内出院。该病例突出了蝎子蜇伤在原本健康女性中的严重表现。如果在蝎子蜇伤患者出现心脏异常后早期给予哌唑嗪(125 - 250微克),临床症状改善的可能性更大。这种治疗可根据给药时间显著改变蝎子蜇伤的发病率和死亡率。由于该患者的心血管表现以及早期使用哌唑嗪治疗蝎子蜇伤,此病例引起了我们的关注。因此,报告该病例旨在提高医生的认识并保护更易受影响的人群。