Which systemic complication is most commonly seen in severe scorpion envenomation and is responsible for many fatalities associated with these stings?
Anaphylactic shock
Acute hepatic failure
Cardiogenic pulmonary edema
Disseminated intravascular coagulation
Cardiogenic pulmonary edema is the hallmark serious complication of scorpion envenomation. Venom-induced massive catecholamine release and direct myocardial toxicity can precipitate acute left-ventricular failure, leading to pulmonary edema and, in some cases, shock. Pulmonary edema and cardiogenic shock are repeatedly cited as the leading causes of death in both adult and pediatric sting victims. Anaphylaxis, while possible (usually after prior sensitization or during antivenom infusion), is documented only rarely. Acute hepatic failure and disseminated intravascular coagulation have been reported in isolated cases but are not typical or common outcomes.
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