Scorpion-related cardiomyopathy and acute pulmonary edema in a child who is stung by Leiurus abdullahbayrami
MehmetDokur1,MustafaDogan2,Ersen AydinYagmur3
1Necip Fazil City Hospital, Department of Emergency Medicine, 46050, Dulkadiroglu, Kahramanmaras, Turkey
2Pamukkale University School of Medicine, Department of Pediatrics, Kinikli Campus, 20070, Denizli, Turkey
3Manisa Celal Bayar University Alasehir Vocational High School, 45600, Alaşehir, Manisa, Turkey
Keywords: Leiurus; Scorpionism; Cardiomyopathy; Pulmonary edema
Abstract
Venom of Leiurus abdullahbayrami (Scorpiones: Buthidae) is an extremely toxic one and it stimulates voltage-gated sodium and potassium channels. In case of a stung by this scorpion; excessive catecholamine release occur and it impairs left ventricle contractility and consequently a heart failure occurs (scorpion sting-related cardiomyopathy). In addition to this cardiac-induced acute pulmonary, edema may occur in severe cases too. An 11-year-old male child who was stung by a scorpion (species: Leiurus abdullahbayrami) consulted to the Emergency Room. Even after 7 h of scorpion envenomation he was confused and having hallucinations. Besides he was dyspneic, tachycardic, hypotensive and got worse in overall situation due to cardiogenic pulmonary edema. These clinical findings are concordant with the Level III scorpion envenomation (major systemic manifestations). Positive inotropic agents, diuretics and antiagregant agents used on supportive therapy in his treatment. After 2 weeks he get recovered and discharged from the pediatric intensive care unit. This research is conducted by thinking emergency physicians should learn that Leiurus abdullahbayrami envenomation can cause scorpion-related cardiomyopathy and acute pulmonary edema especially in children.