Question of the Day – Thursday April 12, 2018

Question – The bark scorpion (Centruroides sculpturatus) can deliver envenomation resulting in serious illness. What are the clinical manifestations associate with this envenomation?

Answer- The cited article notes “Clinically this manifests as cholinergic and adrenergic stimulation producing myriad signs and symptoms commensurate with neuro- muscular hyperactivity and parasympathetic stimulation. Tongue and muscle fasciculations, gross skeletal motor hyperactivity, opsoclonus and salivary gland hypersecretion can all be seen as part of the clinical manifestations of Centruroides sculpturatus envenomation. A grading system has been established and classifies the most severe envenomations as Grade III and IV. It is important to highlight that Centruroides sculpturatus produces significant neurotoxicity but is distinct from other scorpions species in that it lacks the ability to cause significant direct cardiac toxicity. (O’Connor AD et al. Severe bark scorpion envenomation in adults. 2018 Clin Tox 56(3):170-174)