Scorpion envenomation and antivenom therapy.

The clinical course and outcome of scorpion envenomation in 52 children treated in a pediatric intensive care unit without specific antivenom were retrospectively evaluated and compared with those of scorpion envenomation in the 52 preceding cases treated with specific scorpion antivenom. The demographic, clinical, and laboratory features on hospital arrival were similar in the two groups. The lengths of stay in the pediatric intensive care unit and in the pediatric wards were comparable. Hypotension with pulmonary edema developed in four of the children who did not receive antivenom and in one child who did receive antivenom as a complication of the envenomation; all completely recovered. Cardiogenic shock occurred in one child who did not receive antivenom, but who recovered completely, and in three children who received antivenom, of whom two died and one survived with a major deficit. Our study 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, randomized study appears to be warranted. Such a study may define specific subgroups that may benefit from treatment with antivenom.