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Scorpion Stings

by Robert A. Barish, MD, MBA, Thomas Arnold, MD

The stings of North American scorpions are rarely serious and usually result in pain, minimal swelling, tenderness, and warmth at the sting site. However, the bark scorpion ( Centruroides exilicauda or sculpturatus ), which is present in Arizona and New Mexico and on the California side of the Colorado River, has a much more toxic sting. The sting is painful, sometimes causing numbness or tingling in the area around the sting. Serious symptoms are more common in children and include

  • Abnormal head, eye, and neck movements

  • Increased saliva production

  • Sweating

  • Restlessness

Some people develop severe involuntary twitching and jerking of muscles. Breathing may become difficult.

The stings of most North American scorpions require no special treatment. Placing an ice cube wrapped in plastic and a thin cloth on the wound reduces pain. A cream or ointment containing an antihistamine, an anesthetic, a corticosteroid, or a combination of them is often useful. Centruroides stings that result in serious symptoms may require the use of sedatives, such as midazolam, given intravenously. Centruroides antivenom rapidly relieves symptoms, but it may cause a serious allergic reaction. The antivenom is available only in Arizona. It is given only if symptoms are severe.

In areas of the world where scorpions are more poisonous, such as Turkey, the Middle East, and India, stings are treated with drugs and methods that reduce symptoms and complications. Prazosin, an alpha-adrenergic blocking drug, is sometimes used. Antivenins to specific scorpion venoms are available, but their effectiveness has not been proven.

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