CARDIOPULMONARY COMPLICATIONS ASSOCIATED WITH SCORPION POISONING IN PEDIATRIC PATIENTS

Abstract

More than 1.2 million accidents involving scorpion poisoning are recorded every year. In Brazil, scorpion envenomation is the most common cause of venomous animal accidents. The mortality rate is approximately 0.15%, and it is more common in the pediatric population. Cardiogenic shock and acute pulmonary edema are the main causes of death in scorpionism. This article aims to report the pathophysiological changes, clinical presentations, and laboratory and imaging alterations of the main cardiovascular complications of scorpionism in pediatric patients, as well as a general approach to their clinical management. Scorpion envenomation triggers high concentrations of catecholamines and acetylcholine in the bloodstream, which are responsible for the development of the main cardiopulmonary alterations. Cardiac markers such as troponin and CK-MB are increased in these patients, as well as hyperglycemia and hypokalemia. Cardiac arrhythmias, hypokalemia, and cardiac ischemia are observed on the electrocardiogram. Cardiopulmonary complications are caused by transient left ventricular systolic dysfunction. Treatment is based on symptomatic therapy, support of vital conditions, and anti-scorpion serotherapy, as well as anti-tetanus prophylaxis.