Clinical comparison of scorpion envenomation by Androctonus mauritanicus and Buthus occitanus in children

The clinical results of scorpion stings by Androctonus mauritanicus (Am) and Buthus occitanus (Bo) (main sources of scorpionism in Morocco) were evaluated in this work. The objective was to compare the clinical manifestations of envenoming from these species by investigating possible correlations among symptoms/signs and laboratory abnormalities of envenomed patients. 41 children (25 males, 18 months 11 years) were admitted at the Provincial Hospital of El Jadida-Morocco. Their minor (18 children) or severe (23 children) systemic signs such as pallor (48.8%), pulmonary edema (APE) (36.6%), convulsion (26.8%), coma (7.3%) were more frequent in children envenomed by Am than Bo, but angioedema (Quincke's edema) (4.9%) was particularly developed in the latter group. The laboratory blood abnormalities (hyperglycemia, high levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatinine, bilirubin, leukocytes, neutrophils, monocytes, platelets and low levels of lymphocytes and hemoglobin) were significantly higher (p<0.05) in patients envenomed by Am than Bo, and in all population in comparison to control group. The correlation among these biological analyzes and clinical status showed that higher levels of LDH and value of leukocytes >= 19 x 10(3)/mm(3) were indices of cardiac dysfunction with APE. Pallor sign was correlated with a state of shock and/or low level of hemoglobin, associated or not to bilirubin increase. Fatalities (7.3%), presenting toxic myocarditis, had lowest count of lymphocytes (<= 4.2%) in comparison to survivors. This is the first report on lymphopenia which may be useful for forecast the fatal outcome in scorpion envenomation. (C) 2014 Elsevier Ltd. All rights reserved.