Indian red scorpion (Mesobuthus tamulus) envenomation causes a unique syndrome predominantly mediated by massive catecholamine surge. Which of the following manifestations distinguishes this from other scorpion envenomation worldwide?

• A Local tissue necrosis at the sting site
• B Paralytic ileus with absent bowel sounds and hepatic failure
• C Haemolytic anaemia with intravascular haemolysis and haemoglobinuria
• D Acute pulmonary oedema, hypertensive crisis, and autonomic storm without significant neurotoxicity ✓

Explanation

Mesobuthus tamulus venom contains toxins that trigger massive sympathetic and parasympathetic discharge with a net effect of catecholamine storm. Clinically this causes hypertensive crisis, severe pulmonary oedema (from increased left ventricular end-diastolic pressure and pulmonary capillary leak), myocardial failure, and cold extremities. This cardiovascular autonomic storm distinguishes Indian red scorpion from North American/North African scorpions, which predominantly cause neurotoxicity (fasiculations, seizures). Prazosin (alpha-blocker) is the specific treatment for Indian red scorpion envenomation.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.