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Yellow Scorpion Bite: Ignore or Take it Seriously?

AUTHORS

Kourosh Azizi 1 , Armin Akbarzadeh 2 , * , Mohamed Amin Ghobadifar 3

AUTHORS INFORMATION

1 Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, IR Iran

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran

3 Faculty of Medicine, Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, IR Iran

How to Cite: Azizi K, Akbarzadeh A, Ghobadifar M A. Yellow Scorpion Bite: Ignore or Take it Seriously?, Iran Red Crescent Med J. 2016 ; 18(12):e59045. doi: 10.5812/ircmj.28942.

ARTICLE INFORMATION

Iranian Red Crescent Medical Journal: 18 (12); e59045
Published Online: August 30, 2016
Article Type: Letter
Received: March 31, 2015
Revised: January 21, 2016
Accepted: April 18, 2016
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Keywords

Scorpion Envenomation Mesobuthus eupeus Hemiscorpius lepturus

Copyright © 2016, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

Dear Editor,

Scorpion stings are a major public health problem in many countries. The southern areas of Iran are characterized by a warm and dry climate. Many species of scorpion are found in Iran, some of which are dangerous (1, 2). Among the different species found in this area, yellow colored scorpions are more prevalent, with the two main species being Mesobuthus eupeus and Hemiscorpius lepturus (3). Both of these species are prevalent; they are both yellow and they are approximately the same size. Distinguishing between the two species is very important because it helps to determine the appropriate treatment and prognosis following a sting. A Mesobuthus eupeus bite is not dangerous and it does not usually cause any complications (3), while Hemiscorpius lepturus venom is dangerous and may cause acute renal failure and even death if it is not properly managed (4).

Fortunately, the two species can be easily distinguished. A Mesobuthus eupeus bite causes severe pain, as well as a burning sensation and swelling at the bite site, while a Hemiscorpius lepturus bite causes little local pain, although it can produce deep and necrotic ulcers at the bite site. Envenomation by Hemiscorpius lepturus scorpions could easily be overlooked or underestimated because of the limited pain at the site of the bite (5). Furthermore, the two species are different in appearance, as shown in Figure 1. The dorsal part (tergum) of Mesobuthus eupeus features irregular black to dark brown stripes and small dark spots, while Hemiscorpius lepturus does not have dark spots on its tergum. Additionally, male Hemiscorpius lepturus scorpions have longer tails than female ones.

Figure 1. Differing Appearances of the Two Common Yellow Scorpion Species
Differing Appearances of the Two Common Yellow Scorpion Species

A, Mesobuthus eupeus characterized by a wide body, tail, and stinger, oval shaped hands with yellow chela fingers, and dark spots on the tergum (dorsal part); B and C, male and female Hemiscorpius lepturus, respectively, characterized by a thin body, tail, and stinger, wide hands with dark colored chela fingers, and without dark spots on the tergum.

Table 1. Differentiating Characteristics of Two Common Yellow Scorpions Found in Iran, Including Their Bite Management
AnatomyHemiscorpius lepturusMesobuthus eupeus
Tergum (dorsal part)Thin and long body without stripes or spotsWide body with irregular black to dark brown stripes and small dark spots
Metasoma (tail)Thin and longThick and short
StingerFine and thinThick
Pedipalp (hand)Wide hands with short, dark colored chela fingersOval hands with long, yellow colored chela fingers
Clinical signs and symptomsLittle local pain, then deep and necrotic ulcers at the bite site, hemolytic, acute tubular necrosis, hemolytic-uremic syndromeSevere pain accompanied by a burning sensation and swelling at the site of the bite, usually no systemic complications unless in young children, the elderly, or those who are hypersensitive to the sting antigens
ManagementAdmission to hospital, anti-venom injection, hydration, observationLocal anesthesia for pain control

The emergency injection of anti-venom and admission to hospital is crucial in cases of Hemiscorpius lepturus envenomation, since it can cause hemolysis and, consequently, acute renal failure in the first 24 hours (6). Although there are guidelines available for health care providers regarding the management of victims of envenomation, the abovementioned points could be helpful for achieving timely and appropriate interventions.

References

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