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Scorpion sting

Overview

Scorpion stings are painful but rarely life-threatening. Young children, and sometimes the very old, are most at risk of serious complications.

In the United States, the bark scorpion, found mainly in the desert Southwest, is the only scorpion species with venom potent enough to cause severe symptoms. Worldwide, only about 30 of the estimated 1,500 species of scorpions produce venom toxic enough to be fatal. But with millions of scorpion stings occurring each year, often in areas with a lack of access to medical care, deaths due to scorpion stings are a significant public health problem in parts of Mexico, South America, North Africa, the Middle East and India.

Healthy adults usually don't need treatment for scorpion stings. But if a child is stung, the same amount of venom may have more-serious consequences, so seek immediate medical care.

Symptoms

Most scorpion stings cause only localized signs and symptoms, such as pain and warmth at the site of the sting. Sometimes these symptoms may be quite intense, even if you don't see redness or swelling.

Signs and symptoms at the site of the sting may include:

  • Pain, which can be intense
  • Numbness and tingling in the area around the sting
  • Slight swelling in the area around the sting

Signs and symptoms related to widespread (systemic) venom effects usually occur in children who are stung and may include:

  • Difficulty breathing
  • Muscle twitching or thrashing
  • Unusual head, neck and eye movements
  • Drooling
  • Sweating
  • Nausea and vomiting
  • High blood pressure (hypertension)
  • Accelerated heart rate (tachycardia) or irregular heart beat (arrhythmia)
  • Restlessness or excitability or inconsolable crying (in children)

As with other stinging insects, such as bees and wasps, it is possible for people who have previously been stung by scorpions to also have allergic reactions with subsequent stings. These subsequent stings are sometimes severe enough to cause a life-threatening condition called anaphylaxis. Signs and symptoms in these cases are similar to those of anaphylaxis caused by bee stings and can include hives, trouble breathing, and nausea and vomiting.

When to see a doctor

Get immediate medical care for a child stung by a scorpion.

Call your local poison control center for advice if you're concerned about a scorpion sting. To reach a poison control center in the United States, call Poison Help at 800-222-1222.

Seek prompt medical care if you've been stung by a scorpion and begin to experience widespread symptoms.

Causes

Scorpions are arthropods — a relative of insects, spiders and crustaceans. The average scorpion is about 3 inches (7.6 centimeters) long. Scorpions have eight legs and a pair of lobster-like pinchers and a tail that curves up. They sting rather than bite, using the stinger in their tails. The venom itself contains a complex mix of toxins that affect the nervous system (neurotoxins).

Scorpions are nocturnal creatures that resist stinging unless provoked or attacked. They can control the amount of venom they release — depending on how threatened they feel — so some stings may be almost entirely venomless.

Risk factors

Certain factors can increase your risk of a scorpion sting:

  • Geography. In the United States, scorpions mainly live in the desert Southwest, primarily Arizona, New Mexico and parts of California. Worldwide, they're found most often in Mexico, NorthAfrica, South America, the Middle East, and India.
  • Environment. Bark scorpions live under rocks, logs and tree bark — hence, the name. You're especially likely to encounter one when you're hiking or camping. Bark scorpions are also the most common house scorpion, hiding in firewood, garbage pails, bed linen and shoes.
  • Travel. Not only are you more likely to encounter more-dangerous scorpions while traveling in certain parts of the world, you might bring them home with you. Scorpions can hide in clothing, luggage and shipping containers.

Complications

The very old and the very young are most likely to die of untreated venomous scorpion bites. The cause is usually heart or respiratory failure occurring some hours after the sting. Very few deaths from scorpion stings have been reported in the United States.

Another possible complication of scorpion stings, though rare, is a severe allergic reaction (anaphylaxis).

Diagnosis

Your history and symptoms are usually all your doctor needs to make a diagnosis. If you have severe symptoms, you may have blood or imaging tests to check for the effects of the venom on your liver, heart, lungs and other organs.

Treatment

Most scorpion stings don't need medical treatment. But if symptoms are severe, you may need to receive care in a hospital. You may be given sedatives for muscle spasms and drugs through a vein (intravenously) to treat high blood pressure, agitation and pain.

The use of scorpion antivenom remains controversial because of concerns about effectiveness, side effects (more of a concern with older, less purified formulations), cost and access to care. Antivenom is most effective if given before symptoms develop, so children seen in remote rural emergency rooms, where access to medical centers and intensive care units is limited, are often treated with antivenom as a precaution. Also, if you have more-severe symptoms, your doctor may recommend the antivenom.

Your treatment will also depend on whether your doctor determines that your signs and symptoms are due to an allergic reaction rather than the effects of the venom.

Lifestyle and home remedies

If a scorpion stings you or your child, follow the suggestions below. Healthy adults may not need further treatment, and these tips can help keep children safe until they see a doctor:

  • Clean the wound with mild soap and water.
  • Apply a cool compress to the affected area for 10 minutes. Remove it for 10 minutes, then reapply it. This helps reduce pain and slow the venom's spread. This is most effective in the first two hours after a sting occurs.
  • Don't consume food or liquids if you're having difficulty swallowing.
  • Take an over-the-counter pain reliever as needed. You might try ibuprofen (Motrin IB, Children's Motrin, others) to help ease discomfort.

Check your or your child's immunization records to be sure a tetanus vaccine is up to date.

Prevention

Scorpions tend to avoid contact. If you live in an area where scorpions are common, prevent chance meetings by doing the following:

  • Remove piles of rocks or lumber from around your house and don't store firewood against the house or inside.
  • Keep grass closely mowed, and prune bushes and overhanging tree branches, which can provide a path to your roof for scorpions.
  • Caulk cracks, install weather stripping around doors and windows, and repair torn screens.
  • Inspect and shake out gardening gloves, boots and clothing that haven't been used for a while. Always wear shoes.
  • When hiking or camping, wear long sleeves and pants and check your sleeping bag for scorpions before you crawl in.
  • When traveling in areas where lethal scorpions are common — especially if you're camping or staying in rustic accommodations — shake out your clothing, bedding and packages often. Sleep under a mosquito net. If you have a known allergy to insect stings, carry an epinephrine injector, such as EpiPen.

If you do find a scorpion near your home or campsite, use tongs to gently remove the scorpion away from people.

Last updated: October 6th, 2016

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