Scorpion envenomation in India is MOST commonly caused by Mesobuthus tamulus (Indian red scorpion). The mechanism of its toxin causes a 'catecholamine storm.' Which of the following clinical presentations is MOST specific to severe M. tamulus envenomation in children?
- A Descending flaccid paralysis with respiratory failure
- B Myocarditis with pulmonary edema, hypertension alternating with hypotension, and hypersalivation ✓
- C Coagulopathy with disseminated intravascular coagulation
- D Hemolysis with hemoglobinuria and acute kidney injury
Explanation
Mesobuthus tamulus venom causes massive release of catecholamines (epinephrine and norepinephrine) and acetylcholine by stimulating both sympathetic and parasympathetic nervous systems. In children, this manifests as autonomic storm with hypersalivation, sweating, cold extremities, severe hypertension followed by hypotension, and most critically — acute myocarditis with cardiogenic pulmonary edema. Prazosin (alpha blocker) is the specific treatment, counteracting catecholamine-mediated vasoconstriction. Flaccid paralysis (A) is characteristic of elapid snakebite. DIC (C) occurs with some viper venoms. Hemolysis (D) is not a feature of 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.