Scorpion envenomation-associated myocarditis: A systematic review.

Autor: Fereidooni R; Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran., Shirzadi S; Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran., Ayatizadeh SH; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran., Bahloul M; Department of Intensive Care, Habib Bourguiba University Hospital. Faculté de medicine de Sfax. Sfax University. Sfax, Tunisia., Tavangar A; Digestive Health Institute, University of California, Irvine Medical Center, Orange, California, United States of America., Zomorodian SA; Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Roshanshad A; School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Ardekani A; Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Apr 05; Vol. 17 (4), pp. e0011219. Date of Electronic Publication: 2023 Apr 05 (Print Publication: 2023).
DOI: 10.1371/journal.pntd.0011219
Abstrakt: Background: Scorpion envenomation is associated with several complications. One of the most serious complications is the cardiac involvement in the form of myocarditis that remains the main reason for mortalities associated with scorpion envenomation. The present review aims to elucidate clinical and paraclinical findings associated with scorpion-related myocarditis, and to explore different management strategies and subsequent outcomes.
Methods: We searched PubMed, Web of Science, Scopus, and Google Scholar for articles related to keywords of myocarditis associated with scorpion envenomation up to May 1, 2022. Each article was carefully reviewed by two independent researchers. In case of disagreement for inclusion, we sought a third researcher opinion.
Results: A total of 703 cases from 30 case reports and 34 case series were included in our review. Myocarditis associated with scorpion envenomation was usually reported in children presenting with cardiopulmonary symptoms including pulmonary edema (60.7%) and shock or hypotension (45.8%). The most common ECG findings are sinus tachycardia (82%) followed by ST-T changes (64.6%). The management typically included inotropes (especially dobutamine), prazosin, diuretics, nitroglycerine and digoxin, when indicated. Mechanical ventilation was required in 36.7% of the patients. Mortality in confirmed scorpion-related myocarditis cases is estimated at 7.3%. Almost all survived cases showed rapid recovery and improvement in the left ventricular function.
Conclusion: Even though myocarditis associated with scorpion envenomation is rare, it remains a serious and in some of cases a fatal consequence of scorpion sting. In case of relative presentations, particularly in envenomed children, diagnosis of myocarditis should be considered. Early screening using serial cardiac markers and echocardiography can guide the treatment. Prompt treatment that focuses on cardiogenic shock and pulmonary edema usually results in a favorable outcome.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Fereidooni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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