Clinical Management and Epidemiology of Scorpion Stings in Khuzestan Province, Iran: A Five-year Study
Five-year Study of Scorpion Stings in Khuzestan Province
Keywords:
Scorpion; Clinical Signs; Laboratory SignsAbstract
Background: Scorpion stings are a significant public health concern in many countries, particularly in Iran’s Khuzestan province. This study investigates the clinical and laboratory correlations in patients hospitalized for scorpion stings at Razi Hospital, Ahvaz, Iran, from 2018 to 2022, aiming to enhance patient care and preventive strategies.
Materials and Methods: This descriptive, cross-sectional, retrospective study employed census sampling. Age, gender, sting season, sting site, delay to visiting hospital, hospitalization duration, antiscorpion treatment vials prescription, clinical symptom and laboratory findings were collected from medical records of patients hospitalized for scorpion stings during the study period, using a standardized checklist for clinical and laboratory parameters.
Results: Our analysis of 799 scorpion sting cases revealed a male predominance (55.9%) and the highest incidence among individuals aged 21–40 years, with most stings occurring in summer. The extremities, particularly hands and feet, were the most common sting sites. Pain, erythema, and swelling were the leading symptoms, with most patients seeking medical care within three hours. Hospitalization was common, typically lasting at least one day. Disturbances in urinalysis (U/A) were the most frequent laboratory abnormality. Younger women in intensive care exhibited severe symptoms, including seizures, jaundice, and hematuria, which correlated with abnormalities in CBC, biochemical markers, PT, and U/A. These findings highlight the importance of timely clinical and laboratory assessments to improve outcomes. Conclusion: Scorpion stings continue to represent a public health challenge with a range of clinical manifestations and laboratory correlations. By enhancing awareness and preparedness, we can mitigate the impact of this health concern and improve patient outcomes for those affected by scorpion envenomations.
References
Rahmani A, Forouzandeh H, Kalantar M, Asad-Masjedi N, Alavian Z, Kavarizadeh K. Epidemiological and clinical characteristics of scorpion stings in Ahwaz, Southwest Iran (2006-2010). Int J Med Toxicol Forensic Med. 2015;5(4):201-6.
Khanbashi S, Khodadadi A, Assarehzadegan MA, Pipelzadeh MH, Vazirianzadeh B, Hosseinzadeh M, et al. Assessment of immunogenic characteristics of Hemiscorpius lepturus venom and its cross-reactivity with venoms from Androctonus crassicauda and Mesobuthus eupeus. J Immunotoxicol. 2015;12(3):217-22.
https://doi.org/10.3109/1547691X.2014.927542
PMid:24946724
Rahmani A, Jalali A. Symptom patterns in adult patients stung by scorpions with emphasis on coagulopathy and hemoglubinuria. J Venom Anim Toxins Incl Trop Dis. 2012;18:427-31.
https://doi.org/10.1590/S1678-91992012000400011
Bavani MM, Saeedi S, Saghafipour A. Spatial distribution of medically important scorpions in Iran: A review article. Shiraz E Med J. 2021;22(5): e102201.
https://doi.org/10.5812/semj.102201
Hussen F, Erdek M, Yağmur E. External morphology of Hemiscorpius lepturus Peters, 1861 (Scorpiones: Hemiscorpiidae). Arthropoda Sel. 2023;32(4):419-437.
https://doi.org/10.15298/arthsel.32.4.06
Jalali A, Pipelzadeh M, Seyedian R, Rahmani A, Omidian N. In vivo pharmacological study on the effectiveness of available polyclonal antivenom against Hemiscorpius lepturus venom. J Venom Anim Toxins Incl Trop Dis. 2011;17:142-9.
https://doi.org/10.1590/S1678-91992011000200004
Dehesa-Davila M, Alagon AC, Possani LD. Clinical toxicology of scorpion stings Handbook of clinical toxicology of animal venoms and poisons. CRC press: 2017; 221-38.
https://doi.org/10.1201/9780203719442-18
Khattabi A, Soulaymani-Bencheikh R, Achour S, Salmi L-R. Classification of clinical consequences of scorpion stings: consensus development. Trans R Soc Trop Med Hyg. 2011;105(7):364-9.
https://doi.org/10.1016/j.trstmh.2011.03.007
PMid:21601228
https://nursingdabadanumsacir/portal/home/?288112/.
Boubekeur K, L'Hadj M, Selmane S. Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria. Epidemiol Health. 2020;42:e2020050.
https://doi.org/10.4178/epih.e2020050
PMid:32660217 PMCid:PMC7871152
Mousavi SA, Rashidi H, Faramarzi A, Feyzi R, Kaidkhordeh M, Fard PF. Epidemiology of Scorpion Sting in Southwestern Iran Over Five Years. Trends med sci. 2023;3(1):e133418.
https://doi.org/10.5812/tms-133418
Mashhadi I, Kavousi Z, Peymani P, Ramhormozi SSZ, Keshavarz K. Economic burden of scorpion sting and snake bite from a social perspective in Iran. Shiraz E Med J. 2017;18(8):e57573.
https://doi.org/10.5812/semj.57573
Shahrabadi E, Moradi M, Rezaeian M, Salimabadi Y, Esmaeili Ranjbar A, Moinaddini S et al. The epidemiological study of clinical signs and outcomes of patients with scorpion stings referred to emergency department of Rafsanjan Ali-Ibn-Abitaleb Hospital in 2017-2018: a descriptive study. J Rafsanjan Univ Med Sci. 2020;19(7):713-26.
https://doi.org/10.29252/jrums.19.7.713
Bosnak M, Ece A, Yolbas I, Bosnak V, Kaplan M, Gurkan FJW et al. Scorpion sting envenomation in children in southeast Turkey. Wilderness & environmental medicine. 2009;20(2):118-24.
https://doi.org/10.1580/07-WEME-OR-098RR3.1
Queiroz AM, Sampaio VS, Mendonça I, Fé NF, Sachett J, Ferreira LCL et al. Severity of scorpion stings in the Western Brazilian Amazon: a case-control study. PLoS One. 2015;10(6):e0128819.
https://doi.org/10.1371/journal.pone.0128819
PMid:26061734 PMCid:PMC4465172
Polis GA. Seasonal patterns and age-specific variation in the surface activity of a population of desert scorpions in relation to environmental factors. J Anim Ecol. 1980; 49(1):1-18.
Tobassum S, Tahir HM, Zahid MT, Gardner QA, Ahsan MM. Effect of milking method, diet, and temperature on venom production in scorpions. J Insect Sci. 2018;18(4):19.
https://doi.org/10.1093/jisesa/iey081
PMid:30169760 PMCid:PMC6121513
Shahsavarinia K, Taghizadieh A, Ghaffarzad A, Shariati A, Rahmani F. Epidemiological and clinical status of patients with scorpion sting: emergency department of Sina hospital in Tabriz-Iran. J emerg pract trauma. 2017;3(1):18-21.
https://doi.org/10.15171/jept.2017.08
Vaucel J, Labadie M, Hoarau M, Kallel H. Pediatric scorpionism in French Guiana: Epidemiological and clinical study-Preliminary result. Ann Toxicol Anal. 2019;31(2):S29.
https://doi.org/10.1016/j.toxac.2019.03.033
Al-Asmari AK, Al-Saif AAJSmj. Scorpion sting syndrome in a general hospital in Saudi Arabia. Saudi medical journal. 2004;25(1):64-70.
Duru M, Karakuş A, Yengil E, Sahan M, Zeren C, Kekec Z et al. Demographic, clinic and laboratory characteristics of cases presented to emergency department with scorpion sting: 345 cases over a 4-years period. Acta Medica Mediterranea. 2013;29:611-6.
Jaberhashemi SA, Amiri Z, Norouzi M, Shahi M. Epidemiological Factors and Indicators Related to Venomous Bites and Stings in High-risk Areas of Southern Iran. J Prev Med. 2023;10(1):36-47.
Soleimani G, Shafighi Shahri E, Shahraki N, Godarzi F, Soleimanzadeh Mousavi SH, Tavakolikia Z. Clinical and Laboratory Findings and Prognosis of Snake and Scorpion Bites in Children under 18 Years of Age in Southern Iran in 2018-19. Int J Pediatr. 2021;9(1):12795-804.
Mahshidfar B, Ghafouri HB, Yasinzadeh MR, Mofidi M, Rezai M, Farsi D et al. Demographics of scorpion sting in Iran; a cross sectional study. Emergency. 2017;5(1): e77.
Valavi E, Amuri P, Ahmadzadeh A Cheraghian B, Ahankoob E. Acute kidney injury in Hemiscorpius lepturus scorpion stung children: risk factors and clinical features. Saudi J Kidney Dis Transpl. 2016;27(5):936-41.
https://doi.org/10.4103/1319-2442.190841
PMid:27752001
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Galen Medical Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
