Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation?
Scorpion stings can cause a range of reactions which includes severe systemic
envenomation resulting in respiratory failure, cardiovascular collapse, and severe neurologic
complications. Patients with allergies to scorpion venom or allergies to bee and ant venom
can have anaphylactic reactions following scorpion stings. We report a patient who developed
severe respiratory distress following 2-3 scorpion stings on her face. She required an
emergency cricothyroidotomy and prolonged hospitalization, related in part to underlying
comorbidity. Physicians caring for patients following scorpion stings need to remember that
these patients can have severe reactions to the venom, including anaphylactic reactions. The
initial management likely involves respiratory and cardiac resuscitation. These patients may
have a very difficult intubation and require an emergency surgical airway.
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