Sympathomimetic toxidrome: is it scorpion envenomation or methamphetamine?

Centruroides sculpturatus 2.5 out of 5 stars Methamphetamine Ingestion Misdiagnosed as Centruroides sculpturatus Envenonmation. Strommen J, Shirazi F. Case Rep Emerg Med Epub 2015 Jan 14. Full Text Native to the American southwest and Mexico, Centruroides sculpturatus is the most venomous scorpion in North America. Its venom contains a variety of toxins, including α-toxins that inhibits deactivation of voltage-gated sodium channels causing excitation of both the sympathetic and parasympathetic autonomic systems. In addition, the venom causes catecholamine release. Sympathetic effects usually predominate. Patients often present with pain at the site of envenomation. This case report describes a 17-month-old girl brought to the emergency department with sudden onset irritability, twitching and sweating. Examination revealed tachycardia, mydriasis, rotary nystagmus, and findings “consistent with excessive salivation, although there were no pooling secretions in the pharynx.” Because C. sculpturatus are common where the child lived and the mother reported seeing them around her home, the treating clinicians suspected scorpion envenomation, and the child received 3 vials of Anascorp antivenin. The authors report that within 30-40 minutes of receiving Anascorp, the child’s nystagmus disappeared and her “secretions resolved.” However, tachycardia continued and the rectal temperature went up to 102oF. Further history revealed that the child’...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical anascorp antivenom centruroides sculpturatus methamphetamine scorpion sting sympathomimetic toxidrome Source Type: news