Scorpion (Alacrán) Stings

Of the more than 1,000 species of scorpions worldwide, only 30 carry a toxin that may be fatal in humans. In the U.S., the rate is very low: one death from a scorpion sting occurs on average every two to three years. In Mexico, there are a reported 1,000–2,000 deaths per year. Because of their size and ability to travel in shoes and luggage, scorpions are found in many ports all over the world, having arrived as stowaways. Scorpions are nocturnal, typically emerging only at night. They are commonly found in cupboards, closets, in shoes, and under beds. Scorpions sting with a poisoned hook on the tail, which is raised prior to an attack.

Being infected by scorpion venom results in a local reaction that, while painful, is easily treated with analgesics, antihistamines, ice, and supportive care. Moderate to severe pain, numbness, or tingling is often experienced in the area around the sting. Nausea or vomiting is not uncommon.

In more serious stings, pain and tingling may be followed by marked changes in blood pressure (high or low), high fever, or difficulty breathing. Symptoms that signify a more serious venom reaction include restlessness, rotary or roving eye movements, involuntary muscle spasms, difficulty swallowing, excessive salivation, or blurred vision. Shock or respiratory arrest may ensue without prompt medical intervention.

Treatment

Elevate the injured limb at or above the heart. An ice cube may limit pain to the wound. Analgesics such as Tylenol or Ibuprofen may be taken for minor pain. Intravenous or intramuscular injections of meperidine (Demerol) or morphine may be used if the pain is severe. Calcium gluconate (10 ml of 10% solution) may be given intravenously for muscle spasms. Valium may be given intravenously for anxiety and restlessness.

As to antivenom, this is available in most Mexican hospitals for more serious stings. There is always the possibility of a severe allergic reaction to the antivenom; thus, it must be administered by a physician in a hospital setting. The antivenom is primarily used for severe reactions to the venom of the Centruoides Exilicauda scorpion, a small, light brown, inch-long creature also known as a “bark scorpion.” This scorpion is found in Mexico and the southwestern United States.