A study of clinical profile and ECG changes in scorpion sting envenomation in a tertiary care hospital, Nandyal

 

Manchala Pratap Reddy^1*, Pogula Nagarjuna Reddy², G.Vijaya Kumar³

 

Abstract              Background: Scorpions are predatory arachnids which are threatening human beings since centuries. There are about86 species of scorpions found in India. In India, three species Hottentotta (previously called Mesobuthus tumulus), Palamneus swammerdami, and Heterometrus bengalensis are of medical importance. Scorpion envenomation is common in many parts of the world, particularly the tropical and subtropical regions. Morbidity and mortality depend on the time lapse between sting bite and hospitalization. Aim: To study the clinical profile, ECG changes, andto assess the outcome of patients in scorpion sting envenomation among the study group admitted in a tertiary care hospital. Materials and Methods: A Hospital-based Prospective study was conducted in the Department of Medicine, Santhiram medical college and general hospital for a six monthsperiod. Universal Sampling Technique was used for the selection of study subjects. All the patients coming to the medicine department during the study period with age >15 years and Patients with scorpion sting envenomation were taken for study after taking prior informed consent. The final sample size was 50 subjects. Results: Mean of study subjects was 28 years (range from 15-70 years) with M: F ratio of 1.63:1.Pain at the site of sting(100%), Paresthesia(56%) ,Swelling (50%),profuse sweating(62%),Excessive salivation( 28%),Nausea andvomiting(22%) ,Cough(36%), dyspnea(32%) , palpitation(18%) ,Blurring of vision (12%),Pain abdomen (10%), altered sensorium (8%) among study group. ECG changes were observed in 44(88%) of patients with Sinus tachycardia being the commonest finding, and others include first degree AV block, prolonged PR interval, and ST-T changes. Out of 50 patients, one patient died due to myocarditis and pulmonary edema, one patient developed hemiparesis and discharged with residual weakness, and the majority of patients (96%) recovered completely. Conclusion: When agricultural activities are high, and scorpions come out due to the sudden rise in temperature. Myocarditis and pulmonary oedema are fatal complications that require urgent attention and ICU care for a few hours to days. Illiteracy, ignorance, poverty, traditional faith healers trying treatment in remote areas lack transport and nonavailability of ventilation facilities in the nearby hospitals and to delay inappropriate treatment.

Key Word: scorpion sting envenomation.