Cardiac involvement and its complications about three cases of severe scorpion envenomation

For several decades, Morocco is confronted to medico-social problem of scorpion stings and envenomations. In 2009, epidemiological data established by the Poison Control Center recorded 29,816 stung patients, with an incidence of 1.1 parts per thousand. and a fatality rate of 0.18%. The neurotoxins from scorpion venom are potent activators of the autonomic nervous system resulting a physiopathological disorder of vital systems. The most serious clinical manifestations are neurotoxic effects, pulmonary edema and cardiovascular distress. This present work reports the cases of three children (4 years and 6 months, 8 months and 15 days, 4 years), hospitalized in intensive care for an envenomation by Androctonus mauritanicus (the most fatal scorpion specie). The children presented cardiac dysfunction where pulmonary edema and state of shock were complications resultants. Two cases survived after supportive and symptomatic treatment based on dobutamine as primordial treatment in cardiovascular and pulmonary correction and other drugs. The third case died. The objective of this work was to detect the limit of the effectiveness of symptomatic treatment during a severe scorpion envenomation. (C) 2013 Elsevier Ltd. All rights reserved.