Pediatric scorpionism in northern Amazonia: a 16-year study on epidemiological, environmental and clinical aspects

Abstract Background: The Amazon basin is one of the seven major geographical areas where scorpionism is recorded. In French Guiana, 90 stings per 100,000 inhabitants are registered per year. As the severity of cases is higher in children, descriptive studies are needed to have a better understanding of this pathology. The aim of the present study is to describe pediatric scorpionism in French Guiana. Methods: We conducted a monocentric descriptive retrospective study on scorpion stings in all pediatric patients admitted to Cayenne General Hospital from January 1, 2002 to December 31, 2018. Results: In this survey, 132 patients were included. Of them, 63% were male. Patients with general signs of envenomation were younger and lighter (p = 0.04). The picture was “one sting” (95.3%) by a “big” (47.6%), “black” (60%) and “small pincer” (58%) scorpion on the extremity of the body (84%). Stings occurred mainly during the day, while patients changed clothes. There was no envenomation during night. The monthly evaluation highlights that the number of stings and percentage of general signs of envenomation were closely connected to a composite variable including the variation of the level of rivers (p = 0.005). Cardiac symptoms were recorded in 82% of cases with general signs of envenomation. The presence of pulmonary; ear, nose, and throat (ENT); or gastrointestinal symptoms are related to major envenomation (p = 0.001, p = 0.01, and p = 0.02 respectively). Leukocytosis and glycemia increased according to the envenomation grade whereas serum potassium and alkaline reserve decreased. Forty-six patients needed hospitalization and seven of them required intensive care. No patient died nor presented sequelae at discharge from the hospital. Conclusion: Pediatric scorpionism in French Guiana is closely associated with child activities and climatic conditions. Severe envenomation presented most of the time with cardiac, pulmonary, and gastrointestinal symptoms.

摘要
背景：亚马逊盆地是全球七个主要记录蝎毒中毒的地理区域之一。在法属圭亚那，每年每10万人中就有90人记录到被蜇事件。由于儿童病例的严重程度较高，因此需要进行描述性研究以更好地理解这一病理。本研究的目的是描述法属圭亚那的儿童蝎毒中毒情况。
方法：我们对2002年1月1日至2018年12月31日期间入住卡宴综合医院的全部儿科患者进行的蜇伤进行了单中心描述性回顾性研究。
结果：在本调查中，共有132名患者被纳入研究。其中，63%为男性患者。具有中毒一般症状的患者年龄较轻，体重较轻（p = 0.04）。病例以“单蜇”为主（95.3%），蜇伤由“大型”（47.6%）、“黑色”（60%）和“小钳”（58%）的蝎子在身体 extremity 部位造成（84%）。蜇伤主要发生在白天，患者在更换衣物时发生。夜间无中毒事件。月度评估显示，蜇伤数量和中毒一般症状的百分比与河流水平变化的相关复合变量密切相关（p = 0.005）。82%的中毒一般症状病例记录了心脏症状。存在肺部、耳鼻喉（ENT）或胃肠道症状与严重中毒相关（p = 0.001，p = 0.01和p = 0.02）。白细胞计数和血糖水平随中毒程度增加而升高，而血清钾和碱性储备则降低。46名患者需要住院治疗，其中7名患者需要重症监护。没有患者死亡，也没有患者在出院时出现后遗症。
结论：法属圭亚那的儿童蝎毒中毒与儿童活动及气候条件密切相关。大多数严重中毒病例均表现为心脏、肺和胃肠道症状。