[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Scorpion envenomation (Tityus)

[Conditions](https://durgical.com/en/conditions/) · [Emergency medicine and toxicology](https://durgical.com/en/conditions/)

# Scorpion envenomation (Tityus)

A scorpion sting usually causes intense local pain, but in children Tityus venom can trigger vomiting, heart failure, lung fluid and pancreatitis.

Updated 2026-11-01

## Structures involved

Tap one to see what it is and open it in 3D.

- [Pancreas](https://durgical.com/en/anatomy/pancreas/)
- [Skin](https://durgical.com/en/anatomy/skin/)
- [Left ventricle](https://durgical.com/en/anatomy/left-ventricle/)
- [Sinoatrial (SA) node](https://durgical.com/en/anatomy/sinuatrial-node/)
- [Pancreatic duct](https://durgical.com/en/anatomy/pancreatic-duct/)
- [Ampulla of Vater](https://durgical.com/en/anatomy/hepatopancreatic-ampulla/)
- [Trachea](https://durgical.com/en/anatomy/trachea/)

## Why it happens

- [Ion channels and gating](https://durgical.com/en/physiology/ion-channels-and-gating/)
- [The nerve action potential](https://durgical.com/en/physiology/the-nerve-action-potential/)
- [Sympathetic and parasympathetic effects on each organ](https://durgical.com/en/physiology/sympathetic-and-parasympathetic-effects-on-each-organ/)
- [Physiology of pulmonary edema](https://durgical.com/en/physiology/physiology-of-pulmonary-edema/)

## What it is

Poisoning from a scorpion sting («escorpionismo» or «alacranismo»). In Colombia the medically important genera are Tityus and, less often, Centruroides. Most stings cause only local pain, but the venom can provoke a massive release of neurotransmitters (an autonomic storm) that affects the heart, lungs, [pancreas](https://durgical.com/en/anatomy/pancreas/) and [nervous system](https://durgical.com/en/anatomy/system/nervous-system/).

## Who gets it

Scorpionism is an underrecognised public-health problem in Colombia, with dozens of Tityus species and several of medical importance. Serious and fatal cases have been described in Antioquia, Tolima, Huila, Boyacá, Caldas and Cundinamarca. Children have the highest risk of severe envenomation, and many stings occur inside homes.

## Causes

- Sting by Tityus species (e.g. T. pachyurus, T. asthenes) or Centruroides species
- Contact with scorpions hidden in shoes, clothing, bedding or building rubble

## Risk factors

- Age under 10 years (and older adults)
- Living in houses with cracks, rubble or wood stores
- Rural or peri-urban homes in warm valleys
- Delay in reaching medical care
- Underlying heart disease

## Pathophysiology

Scorpion neurotoxins act on voltage-gated sodium and potassium channels, prolonging nerve depolarisation. This causes massive release of acetylcholine and catecholamines. Cholinergic effects include vomiting, sweating, sialorrhoea, bradycardia and bronchorrhoea; adrenergic effects include tachycardia, hypertension and hyperglycaemia. Catecholamine surge and direct toxicity produce myocardial dysfunction, cardiogenic shock and pulmonary oedema. Venom also stimulates pancreatic secretion and can cause acute pancreatitis, a classic association with Tityus.

## Classification

- Mild: local pain, paraesthesia, mild local swelling only
- Moderate: local signs plus systemic signs such as vomiting, sweating, sialorrhoea, tachycardia or hypertension, agitation
- Severe: repeated vomiting, cardiac dysfunction, shock, pulmonary oedema, arrhythmias, seizures or coma

## Symptoms and signs

- Intense burning pain at the sting site, paraesthesia radiating along the limb
- Vomiting (repeated vomiting predicts severity in children)
- Sweating, drooling, tearing and runny nose
- Abdominal pain
- Tachycardia or bradycardia, hypertension then hypotension
- Agitation, tremor, muscle twitching

## Red flags

- Repeated vomiting in a child
- Breathlessness, crackles or pink frothy sputum (pulmonary oedema)
- Hypotension, cold extremities or poor perfusion (cardiogenic shock)
- Arrhythmias, seizures or decreased consciousness
- Severe epigastric pain (acute pancreatitis)

## Diagnosis

**Clinical**
Clinical diagnosis from the history of a sting (ideally with the scorpion or a description) and the clinical grade. Children and moderate or severe cases need observation in a hospital, with repeated grading over the first hours.

**Tests**
In moderate and severe cases: blood glucose (often high), electrolytes, amylase or lipase (pancreatitis), troponin and creatine kinase-MB (myocardial injury), arterial blood gases, renal function and ECG for arrhythmias and ischaemic changes.

**Imaging**
[Chest](https://durgical.com/en/anatomy/region/chest/) X-ray for pulmonary oedema; echocardiography to assess left ventricular dysfunction in severe cases.

## Differential diagnosis

- Spider bite (Loxosceles, Latrodectus)
- Hymenoptera stings with allergic reaction
- Organophosphate poisoning (cholinergic signs)
- Acute pancreatitis or myocarditis of other causes
- Anaphylaxis

## Goal of treatment

Control pain, neutralise venom in systemic cases, and support the heart and lungs through the autonomic storm.

## Treatment

**Acute**
Wash the site, apply cold, keep the limb still and give analgesia; local anaesthetic infiltration for severe local pain. Avoid traditional remedies and incisions.

**Medical**
Specific anti-scorpion antivenom (fabotherapic) for moderate and severe envenomation, as early as possible and with readiness to treat allergic reactions.

**Conservative**
Antiemetics, careful fluid management, and treatment of pulmonary oedema and cardiogenic shock with oxygen, ventilatory support and inotropic agents in intensive care; seizures treated with benzodiazepines.

**Follow-up**
Nursing priorities: continuous cardiac and oxygen monitoring, count of vomiting episodes, blood pressure, glucose, urine output and respiratory signs; close observation of all stung children for at least several hours.

## Complications

- Acute pulmonary oedema
- Myocardial dysfunction and cardiogenic shock
- Arrhythmias
- Acute pancreatitis
- Seizures and encephalopathy
- Death, mainly in young children

## Prognosis

Most stings are mild and resolve within a day. Severe cases in children carry real mortality, mostly from cardiogenic shock and pulmonary oedema, but survivors usually recover without lasting heart damage.

## Prevention

- Shake out shoes, clothing and bedding before use
- Seal cracks, remove rubble and wood piles near the home
- Use bed nets and move beds away from walls in endemic areas

## Test yourself

Think of the answer, then tap the question to see it.

## Which genus causes most severe scorpion envenomations in Colombia?

Tityus, with species such as T. pachyurus and T. asthenes; Centruroides is also present.

## Which abdominal organ is classically inflamed by Tityus venom?

The pancreas: Tityus venom stimulates pancreatic secretion and can cause acute pancreatitis.

## What is the main mechanism of severe systemic scorpion envenomation?

Neurotoxins on sodium and potassium channels cause massive release of acetylcholine and catecholamines, an autonomic storm that injures the heart and lungs.

## Which simple sign in a stung child suggests severe envenomation?

Repeated vomiting, which is an early marker of systemic envenomation and calls for close monitoring and antivenom.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/scorpion-envenomation/)

## Related conditions

- [Acute pancreatitis](https://durgical.com/en/conditions/acute-pancreatitis/)
- [Heart failure](https://durgical.com/en/conditions/heart-failure/)
- [Cardiogenic shock](https://durgical.com/en/conditions/cardiogenic-shock/)
- [Myocarditis](https://durgical.com/en/conditions/myocarditis/)
- [Acute respiratory distress syndrome (ARDS)](https://durgical.com/en/conditions/acute-respiratory-distress-syndrome/)
- [Hypertensive emergency and urgency](https://durgical.com/en/conditions/hypertensive-emergency-and-urgency/)
- [Status epilepticus](https://durgical.com/en/conditions/status-epilepticus/)
- [Organophosphate and carbamate poisoning](https://durgical.com/en/conditions/organophosphate-and-carbamate-poisoning/)
- [Snakebite envenomation (Bothrops, Lachesis, Crotalus)](https://durgical.com/en/conditions/snakebite-envenomation/)
- [Spider bites (loxoscelism and latrodectism)](https://durgical.com/en/conditions/spider-bites/)
- [Anaphylaxis](https://durgical.com/en/conditions/anaphylaxis/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Scorpions: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/002850.htm) (MedlinePlus (U.S. National Library of Medicine), 2026); Guía para el manejo de emergencias toxicológicas (Ministerio de Salud y Protección Social (Colombia) / OPS, 2017).

[← All conditions](https://durgical.com/en/conditions/)

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/conditions/scorpion-envenomation/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/scorpion-envenomation/