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4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Treatment Details

Scorpions

These are eight legged arthropods and have a hollow sting in the last join of their tail, which communicates by means of a duct with the poisonous glands, which secrete poison on stinging. The venom is a clear, colowebsiteess toxalbumin and can be classified as either haemolytic or neurotoxic. Its toxicity is more than that of snakes, but only a small quantity is injected. The venom is a potent autonomic stimulator resulting in the release of massive amounts of catecholamines from the adrenals. It also has some direct effect on the myocardium. The mortality, except in children, is negligible. Colour of scorpions varies from light yellow to black. Most scorpion stings occur on the extremities.

Route : Injection

Clinical picture : If the scorpion has haemolytic venom, the reaction is mainly local and simulates the viperine snake bite, but the scorpion sting will have only one hole in the centre of the reddened area. The extremity will have oedema, pain and reddening. This usually lasts for one to two hours. The symptoms produced by neurotoxic venom are similar to those of a cobra bite. There is usually no marked reaction locally. Nausea, vomiting, extreme restlessness, fever, various types of paralysis, cardiac arrhythmias, convulsions, coma and cyanosis, respiratory depression, and death may occur within hours from pulmonary oedema or cardiac failure. The diagnosis is confirmed by ELSIA testing.

Treatment : 1. Immobilse the limb, and apply a tourniquet above the level of the sting.
2. Pack sting in ice, and incise and use suction, and wash the wound with a weak solution of ammonia, borax or potassium permanganate.
3. A local anaesthetic is injected at the site to lessen pain.
4. A specific antivenin is available for most species.
5. Calcium gluconate intravenously is of value to control local swelling.
6. Barbiturates should be given to reduce excitement and convulsions but morphine is contraindicated.
7. Atropine is valuable in preventing pulmonary oedema.
8. I.V. glucose, saline and hydrocortisone.

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

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