Citation Information :
Bhoite R, Bhoite G, Bagdure D, Bawaskar H. Anaphylaxis to scorpion antivenin and its management following envenomation by Indian red scorpion, Mesobuthus tamulus. Indian J Crit Care Med 2015; 19 (9):547-549.
Mesobuthus tamulus is an Indian red scorpion that is responsible for numerous cases of scorpion stings in the Indian subcontinent. Antivenin, vasodilators, and benzodiazepines are medications of choice in the treatment of scorpion bites. Adverse reactions such as anaphylaxis to antivenin have been infrequently described in the literature. We, herein, present a case of a 42-year-old man stung by Indian red scorpion while gardening at home in India, who presented with extreme pain at the sting site and signs of cardio-toxicity. He was treated with scorpion antivenin and vasodilators but developed anaphylaxis to antivenin. We discuss management strategies. Anaphylaxis to antivenin should be on the differential during management of scorpion bites because classical signs of anaphylaxis may be absent.
Chippaux JP, Goyffon M. Epidemiology of scorpionism: A global appraisal. Acta Trop 2008;107:71-9.
Isbister GK, Bawaskar HS, Brown SG. Scorpion envenomation. N Engl J Med 2014;371:1559-60.
Bawaskar HS, Bawaskar PH. Vasodilators: Scorpion envenoming and the heart (an Indian experience) Toxicon 1994;32:1031-40.
Gwee MC, Nirthanan S, Khoo HE, Gopalakrishnakone P, Kini RM, Cheah LS. Autonomic effects of some scorpion venoms and toxins. Clin Exp Pharmacol Physiol 2002;29:795-801.
Abroug F, Nouira S, El Atrous S, Besbes L, Boukef R, Boussarsar M, et al. A canine study of immunotherapy in scorpion envenomation. Intensive Care Med 2003;29:2266-76.
Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: Randomised open label clinical trial. BMJ 2011 5;342:c7136.
Amaral CF, Dias MB, Campolina D, Proietti FA, de Rezende NA. Children with adrenergic manifestations of envenomation after Tityus serrulatus scorpion sting are protected from early anaphylactic antivenom reactions. Toxicon 1994;32:211-5.
Warrell DA. Antivenom reactions. In: Guidelines for the Management of Snake-bites. India: WHO; 2010.
Pinto MC, Borboleta LR, Melo MB, Labarrére CR, Melo MM. Tityus fasciolatus envenomation induced cardio-respiratory alterations in rats. Toxicon 2010;55:1132-7.
Raab W. Key position of catecholamines in functional and degenerative cardiovascular pathology. Am J Cardiol 1960;5:571-8.