SCORPION ENVENOMATION AND ANTIVENOM THERAPY

The clinical course and outcome of scorpion envenomation in 52 childre n treated in a pediatric intensive care unit without specific antiveno m were retrospectively evaluated and compared with those of scorpion e nvenomation in the 52 preceding cases treated with specific scorpion a ntivenom. The demographic, clinical, and laboratory features on hospit al arrival were similar in the two groups. The lengths of stay in the pediatric intensive care unit and in the pediatric wards were comparab le. Hypotension with pulmonary edema developed in four of the children who did not receive antivenom and in one child who did receive antive nom as a complication of the envenomation; all completely recovered. C ardiogenic shock occurred in one child who did not receive antivenom, but who recovered completely, and in three children who received antiv enom, of whom two died and one survived with a major deficit. Our stud y did not demonstrate any beneficial effect of therapy with antivenom for scorpion envenomation in children. However, our ''control'' group (i.e., the treated group) was a historical one; thus a prospective, ra ndomized study appears to be warranted. Such a study may define specif ic subgroups that may benefit from treatment with antivenom.