|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 8 | Page : 4480
Uncommon presentation of scorpion sting at teaching hospital
Santosh Govind Rathod
Department of Pathology, Subdistrict Hospital Mangaon, Dist Raigad, Maharashtra, India
|Date of Submission||11-Jun-2020|
|Date of Decision||19-Jun-2020|
|Date of Acceptance||20-Jun-2020|
|Date of Web Publication||25-Aug-2020|
Dr. Santosh Govind Rathod
Kool Homes Green Valley, Bavdhan Pune, Maharastra - 411 021
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rathod SG. Uncommon presentation of scorpion sting at teaching hospital. J Family Med Prim Care 2020;9:4480
We read with great interest article by Pradeep et al. in their case, author did not use prazosin in management of sever scorpion sting with pulmonary edema. Scorpion venom includes mixture of low molecular weight peptide toxin, which targets the ion channel. Alfa toxin inhibits the inactivation of neuronal sodium channels and resulting in a sustained depolarization and neuronal excitation. As results of this, there is autonomic storm in the body leading to pouring of endogenous catecholamines (epinephrine and norepinephrin), Neuropeptide –Y and endothelin-1. In severe scorpion sting, sustained Alfa receptor stimulation results in development of pulmonary edema, in addition to catecholamine-induced myocarditis and myocardial ischemia due to Neuropeptide –Y. Epithelial sodium channels, cystic fibrosis transmembrane conductor, and Na/K-ATPase clear the lung edema. Scorpion venom inhibits alveolar fluid clearance through Endothelin-1. As it impairs the fluid clearance in alveoli. This results in development of pulmonary edema. Prazosin is pharmacological antidote of scorpion envenomation. Prazosin inhibiting phospodiestrase, result in cellular accumulation of cyclic GMP-an endothelin inhibitor, clears pulmonary edema, and corrects the hemodynamic and metabolic effects of envenomation. Prazosin reduces preload and increases the left ventricle compliance. Thus in severe case of scorpion envenomation, use of prazosin and dobutamine will reduce overall morality and recovery time. Noradrenalin will worsen the situation as its predominant Alfa -1 agonist action. Poisonous species of scorpions are present all over India. Monospecific scorpion Antivenom should be made available, at all places where scorpion venomation is common. Recently, in scientific trials, it has confirmed that simultaneous use of prazosin and ant scorpion venom use reduces the cardiovascular mortality and morbidity and prevent Extra load of these cases to intensive care unit, which is beyond the reach of poor people.
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Conflicts of interest
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| References|| |
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