Abstract
Objective
To study the effect of the second dose of scorpion antivenom in children with nonresolving or worsening scorpion sting envenomation.
Methods
72 children aged ≤12 years with scorpion sting envenomation grade 2 and above were enrolled. 61 received the first dose of three vials of antivenom at admission (group A). Children with persistent/worsening envenomation within 6 hours received the second dose (group B). The time required for resolution of autonomic symptoms, myocardial dysfunction, predictors of the second dose and side effects were studied.
Results
The mean time taken for resolution of autonomic symptoms were comparable in Group A and B (4.1 vs. 5.3 h, P=0.4), and of myocardial dysfunction was shorter in Group A (10.8 vs. 37.6 h, P=0.02). On regression analysis, abnormal echocardiography at admission was found to be a significant predictor of the second dose (OR=27.6, 95% CI, 4.7–162.5; P=<0.001).
Conclusion
Children with severe scorpion sting envenomation with abnormal echocardiography may require a higher dose of scorpion antivenom.
Trial registration
CTRI/2015/03/005652.
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References
Chippaux J-P, Goyffon M. Epidemiology of scorpionism: a global appraisal. Acta Trop. 2008;107:71–9.
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;342:c7136.
Mahadevan S. Scorpion sting. Indian Pediatr. 2000;37:504–14.
Bawaskar HS, Bawaskar PH. Scorpion sting: update. J Assoc Physicians India. 2012;60:46–55.
Pandi K, Krishnamurthy S, Srinivasaraghavan R, Mahadevan S. Efficacy of scorpion antivenom plus prazosin versus prazosin alone for mesobuthus tamulus scorpion sting envenomation in children: A randomised controlled trial. Arch Dis Child. 2014;99:575–80.
Natu VS, Kamerkar SB, Geeta K, Vidya K, Natu V, Sane S, et al. Efficacy of anti-scorpion venom serum over prazosin in the management of severe scorpion envenomation. J Postgrad Med. 2010;56:275–80.
Kumar PM, Krishnamurthy S, Srinivasaraghavan R, Mahadevan S, Harichandrakumar KT. Predictors of myocardial dysfunction in children with Indian red scorpion (Mesobuthus tamulus) sting envenomation. Indian Pediatr. 2015;52:297–301.
Hammoudi-Triki D, Ferquel E, Robbe-Vincent A, Bon C, Choumet V, Laraba-Djebari F. Epidemiological data, clinical admission gradation and biological quantification by ELISA of scorpion envenomations in Algeria: effect of immunotherapy. Trans R Soc Trop Med Hyg. 2004;98:240–50.
Sevcik C, D’Suze G, Díaz P, Salazar V, Hidalgo C, Azpúrua H, et al. Modelling Tityus scorpion venom and antivenom pharmacokinetics. Evidence of active immunoglobulin G’s F(ab’)2 extrusion mechanism from blood to tissues. Toxicon. 2004;44:731–41.
Ghalim N, El-Hafny B, Sebti F, Heikel J, Lazar N, Moustanir R, et al. Scorpion envenomation and serotherapy in Morocco. Am J Trop Med Hyg. 2000;62:277–83.
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Abimannane, A., Rameshkumar, R., Satheesh, P. et al. Second Dose of Scorpion Antivenom in Children with Indian Red Scorpion (Mesobuthus tamulus) Sting Envenomation. Indian Pediatr 55, 315–318 (2018). https://doi.org/10.1007/s13312-018-1275-7
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DOI: https://doi.org/10.1007/s13312-018-1275-7