Scorpion sting and allergic reaction to scorpion venom: A case-based review.

To describe a young patient with scorpion sting (SS) with typical lesions of urticaria besides the local SS clinical picture. A systematic screening of articles dating from 1966 to 2021 was conducted in the main databases. All articles included the association between SS and urticaria. A new case report is added to the published list. The literature search found 5 articles with 29 patients with SS and urticaria/allergic reactions. We performed our analysis by adding our present case, resulting in a total of 30 cases. Most were male, and their ages varied from 29 to 48 years. Regarding SS severity, most were mild or moderate. In two articles, patients had more than one sting. The allergic reaction varied from urticaria, pruritus, flushing, angioedema, wheezing, rhinorrhea, sneezing, consciousness alterations, and gastrointestinal and cardiovascular alterations. In 5/6 (83%) articles, the patients were alive at the study time. One subject died from anaphylactic shock. The present article systematically reviewed all published cases of SS and allergic reactions to scorpion venom. It is an infrequent association; most patients are male and in the productive age, and reaction may vary from mild to severe, including death.

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None. Table 1.All published cases of scorpionism and associated urticaria/allergy reactions. Author, year [reference]CountryNumber of subjectsAge (years), sexScorpion stingScorpion specimenPrevious episodes of scorpion stingRing and Messmer anaphylactic classification [11]TreatmentTime between sting and symptomsOutcomeCarvalho et al. 2021 (present case)Brazil122, femaleModerateTytius confluensNoGrade I (urticaria over the trunk and upper limbs)Anti-histamine plus glucocorticoid2 hoursAliveMelo et al. 2019 [8]Brazil144, malePossibly severeJaguajir rochaeNoGrade III (anaphylactic shock)Patient was dead upon arrival at the emergency departmentMinutesDeathMore et al. 2004 [4]United States1148 ± 8.8, 64% femaleMild to severeCentruroides vittatusOne caseGrade III (urticaria, pruritus, flushing, angioedema, wheezing, rhinorrhea, sneezing, consciousness alterations, gastrointestinal and cardiovascular alterations)NDNDAliveNugent et al. 2004 [5]United States4NDNDCentruroides vittatusNDNDNDNDAliveLeynadier et al. 1997 [7]Algeria1029.3 ± 21, 90% male90% mild, 10% moderateAndroctonus australis HectorYes, varying from 2 to more than 8 timesNDNDNDAliveDemain et al. 1995 [6]United States338, 53, and 57; all-femaleModerate (n = 1) and severe (n = 2)Centruroides vittatus2 – 5 in all casesGrade IIND1 – 2 minutes to 1 hourAliveND = not described.