Epidemiological and Clinical Characteristics and Outcomes of Scorpion Envenomation in Hospitalized Children in Adiyaman, Turkey

Scorpion envenomation is a public health problem in tropical and subtropical countries. The majority of scorpion sting cases present with local pain at the site of sting and follow a benign clinical course. Severe intoxication may include cardiac and respiratory dysfunc-tion, leading to multi-system organ failure and death (1, 2). The deaths in scorpion sting envenomation (SE) are attributed to cardiopulmonary complications, such as myocarditis and acute pulmonary edema (3). Cases of SE are common in Turkey, especially in Southeast Anatolia, owing to its geographical location, climate and socioeconomic structure (4). However, there is a scarcity of epidemiologic data on SE in Turkey because of the underdeclaration of scorpion sting cases and paucity of studies on the subject. Therefore, this study aims to evaluate the children hospitalized owing to scorpion stings and their epidemiological and clinical characteristics in Adiyaman province. Medical records of 80 patients were retrospectively reviewed to collect the following data: age, gender, clinical symptoms (localized and systemic), vital signs, information about the date and place of the sting occurrence , anatomical sting site, time elapsed between the sting and arrival at the hospital, type of scorpion, severity of the patients' symptoms, treatment modalities and outcomes. The diagnosis of SE was based on the history of scorpion sting. The scorpion type was identified based on the colour of the scorpion defined by the patient or bystander. A. crassicauda and M. eupeus are more commonly known as the black and yellow scorpions , respectively (4). Patients were classified into three classes according to clinical severity as follows: class I: local manifestations; class II: systemic involvement; and class III: cardiovascular, respiratory or neurologi-cal symptoms (such as cardiogenic shock, pulmonary edema, altered consciousness and convulsive crisis) (5). A total of 80 subjects were recruited for this study. Of these, 42 (52.5%) were male and 38 (47.5%) female, with a mean age of 6.5 ± 4.1 years (range: 6 months to 17 years). Moreover, 51 (63.7%) and 29 (36.3%) of these subjects were from rural and urban areas, respectively. In terms of the type of scorpion, 32 (40%) subjects were stung by black scorpions and 27 (33.7%) by yellow scorpions. In 13 (16.3%) cases, the patients could not identify the colour of the scorpions. The most common sting sites were lower extremity (n = 53, 66.2%), upper extremity (n = 17, 21.2%) and body (n = 7, 8.8%). The patients were mostly …