Tityus discrepans ADMITTED TO THE LOS TENQUES GENERAL HOSPITAL, MIRANDA STATE, VENEZUELA.
J. V. Mota
, M. T. Ghersy-Nieto, L. Limardo, A. Ortega
Servicio de Emergencia Pediátrica. Área de Toxicología Médica. Hospital General "Dr. Victorino Santaella Ruiz", Los Teques, Estado Miranda, Venezuela.
Scorpions are widely distributed throughout Venezuela where severe envenomations are usually caused by scorpions of the Tityus genus. There are potentially dangerous areas which coincide with the dispersal of some species, such as Tityus discrepans, the most relevant species from the high regions of Miranda State. This species has been responsible for a high incidence of envenomations over the past 10 years endemic to Los Teques and surrounding areas. The authors demonstrated the prognostic value of plasmatic levels of cholinesterase in relation to the different degrees of toxicity from envenomings by Tityus discrepans. Forty envenomed patients were prospectively studied at the Pediatric Emergency Service of the Los Teques General Hospital. These patients were classified as asymptomatic, mildly, moderately, or severely envenomed, based on clinical and laboratory criteria. Their plasmatic levels of cholinesterase were determined on admission, before, and 24 h after antivenom therapy. The values on admission showed the plasmatic levels of cholinesterase for: mildly envenomed (25%) below normal, moderately envenomed (35%) below normal, and severely envenomed (45%) below normal. The asymptomatic patients did not show any alterations in the plasmatic levels of cholinesterase. Twenty-four hours after antivenom therapy, the plasmatic levels of cholinesterase had partially recovered showing values of 5% below normal in the mildly envenomed, 10% below normal in the moderately envenomed, and 15% below normal in the severely envenomed, while the asymptomatic patients did not show any alterations. This plasma enzyme can be considered a biological marker for the prognosis of scorpionism in its different degrees of toxicity up to the first 24 hours after envenomation. The clinical-epidemiological profile of the 60 patients envenomed by Tityus discrepans (taxonomically identified) between August 1996 and May 1997 treated at the Pediatric Emergency Service of the Los Teques General Hospital were: a) patients aged between18 months and 12 years; b) 60% female (36 cases), while 40% male (24 cases); c) 38.8% from Los Teques, 16.7% from Carrizal, 15% from the old Caracas-Los Teques highway area, 11.7% from the Pan-American highway area, 10% from San Antonio de Los Altos, and 8.3% referred by the health centers from the border areas of Aragua State. The clinical signs were vomiting (50%), abdominal pain (21.8%), mucocutaneous paleness (10.9%), drowsiness (7.3%), sialorrhea and irritability (3.6%), and tachicardia and hypotension (3.8%). Sodium and potassium serum changes in these patients were also evaluated before and after antivenom therapy. The results showed serum variations due to action of the antivenom in these ions for the different degrees of toxicity in scorpion envenoming.
Publication Dates
-
Publication in this collection
16 Apr 1999 -
Date of issue
1999
