Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay.
Hospital General de Macas, Macas, Ecuador.
Am J Trop Med Hyg. 2023 Feb 6;108(4):807-810. doi: 10.4269/ajtmh.22-0681. Print 2023 Apr 5.
Envenomation by scorpions belonging to the genus Tityus can be life threatening in the Americas, particularly in the Amazon Basin. We report a 4-month-old Ecuadorean boy of Shuar origin stung by a scorpion identified as Tityus cisandinus in the Amazonian province of Morona Santiago, presenting with pulmonary edema and systemic inflammation. We administered immunotherapy using the scorpion antivenom available in Ecuador, of Mexican origin (anti-Centruroides). Catecholamine discharge-related events such as hyperglycemia and thrombocytosis were resolved after treatment but leukocytosis did not, suggesting that factors associated with the sting-admission delay and specificity of antivenom played a role in the envenomation outcome. Cardiorespiratory arrest determined a fatal outcome, despite specific maneuvers. The case severity and the limited supply of nonspecific scorpion antivenoms in problematic areas of Amazonian Ecuador and elsewhere in northwestern Amazonia are discussed in regard to the need for specific therapeutic immunoglobulins in the area and in the Amazon Basin as a whole.
在美洲，被蒂图斯属（Tityus）蝎子螫伤可能会危及生命，尤其是在亚马逊盆地。我们报告了一例厄瓜多尔 4 个月大的男孩，他是舒阿尔人（Shuar），在亚马逊省莫罗纳圣地亚哥（Morona Santiago）被鉴定为 Tityus cisandinus 的蝎子螫伤，表现为肺水肿和全身炎症。我们使用在厄瓜多尔可获得的、源自墨西哥的（抗 Centruroides）蝎子抗毒液进行免疫治疗。儿茶酚胺释放相关事件，如高血糖和血小板增多症，在治疗后得到解决，但白细胞增多症没有得到解决，这表明与螫伤入院延迟和抗毒液特异性相关的因素在毒液中毒结局中发挥了作用。心肺骤停导致致命结果，尽管采取了具体措施。该病例的严重程度以及厄瓜多尔亚马逊地区和亚马逊盆地西北部其他地区非特异性蝎子抗毒液的有限供应，都需要在该地区和整个亚马逊盆地使用特定的治疗性免疫球蛋白进行讨论。
