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J Pediatr Intensive Care 2018; 07(04): 219-224
DOI: 10.1055/s-0038-1673624
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Severe Troponin I Elevation and Myocardial Dysfunction in a Child with Scorpion Sting

Nagehan Aslan
1   Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
,
Dincer Yildizdas
1   Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
,
Ozden Ozgur Horoz
1   Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
,
Didar Arslan
1   Division of Pediatric Intensive Care, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
,
Celal Varan
2   Division of Pediatric Cardiology, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
,
Sevcan Erdem
2   Division of Pediatric Cardiology, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey
,
Hayri Levent Yılmaz
3   Division of Pediatric Emergency Care, Department of Pediatrics, Cukurova University, Faculty of Medicine, Adana, Turkey
› Author Affiliations
Further Information

Publication History

21 March 2018

03 June 2018

Publication Date:
03 October 2018 (online)

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Abstract

Background Scorpion sting is a common medical problem and major cause of mortality and morbidity in many countries. The symptoms of envenomation are more severe in the pediatric population. The clinical manifestations of scorpion envenomation appear by activation of sympathetic and parasympathetic nervous system. Envenomation can cause multiorgan dysfunction and death.

Case Presentation and Findings In this case report, we present a pediatric patient from Adana, Southeast Anatolia, with severe scorpion envenomation with Leiurus abdullahbayrami which is an especially dangerous species for children. Severe systolic dysfunction was detected by echocardiography. Troponin I levels elevated significantly and rapidly responded to three doses of antivenom therapy.

Conclusion Early echocardiographic examination is an important procedure for patients with scorpion envenomation. Troponin I is a significant parameter to monitor the degree of cardiac injury. Antivenom therapy is the only recommended specific therapy for children with severe scorpion envenomation due to Leiurus abdullahbayrami. Abnormal echocardiography findings may require repeated doses of scorpion antivenom.

Keywords

child - scorpion - high troponin - three doses of antivenom - severe systolic dysfunction
 

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