Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation?

Abstract

Scorpion stings can cause a range of reactions which includes severe systemicenvenomation resulting in respiratory failure, cardiovascular collapse, and severe neurologiccomplications. Patients with allergies to scorpion venom or allergies to bee and ant venomcan have anaphylactic reactions following scorpion stings. We report a patient who developedsevere respiratory distress following 2-3 scorpion stings on her face. She required anemergency cricothyroidotomy and prolonged hospitalization, related in part to underlyingcomorbidity. Physicians caring for patients following scorpion stings need to remember thatthese patients can have severe reactions to the venom, including anaphylactic reactions. Theinitial management likely involves respiratory and cardiac resuscitation. These patients mayhave a very difficult intubation and require an emergency surgical airway.