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Second Dose of Scorpion Antivenom in Children with Indian Red Scorpion (Mesobuthus tamulus) Sting Envenomation

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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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Authors and Affiliations

  1. Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605 006, India

    Anitha Abimannane, Ramachandran Rameshkumar, Ponnarmeni Satheesh & Subramanian Mahadevan

Authors
  1. Anitha Abimannane
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  2. Ramachandran Rameshkumar
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  3. Ponnarmeni Satheesh
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  4. Subramanian Mahadevan
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Corresponding author

Correspondence to Ramachandran Rameshkumar.

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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

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