Envenimation scorpionique grave : vers un traitement à la carte de la défaillance circulatoire

Despite their scarcity (less than 1% of clinical presentation of overall scorpion stings), severe forms of scorpion envenoming account for the reported mortality related to this dreaded accident. Severe scorpion envenoming corresponds to two varieties of acute heart failure: cardiogenic shock or pulmonary edema. The cardiomyopathy that occur following scorpion envenoming is related to the catecholaminergic storm evoked by scorpion sting. Its pathogeny and clinical behavior are similar to that of stress cardiomyopathy. Diagnosis of cardiogenic pulmonary edema might be hindered by the frequently associated hypovolemia. Treatment of severe forms of scorpion envenoming relies principally on symptomatic measures: oxygenation and ventilatory assistance for pulmonary edema, and dobutamine infusion for cardiogenic shock.