It was almost midnight when Dona Maria, 58 years old, felt a sharp and sudden pain in her right foot when putting on her shoe. Within seconds, a burning sensation took over the entire area and she started sweating cold. Her son found a yellow scorpion on the floor, next to the shoe. His first impulse was to give his mother sugar water and wait for it to pass. Less than an hour later, she was experiencing intense vomiting, a rapid heartbeat and difficulty breathing, ending up in the ICU.

Dona Maria's story is not uncommon. Brazil registers more than one million scorpion stings per year, according to the Ministry of Health. The main mistake that puts lives at risk is always the same: the delay in seeking medical care and taking wrong measures instead of the right ones.

The Most Dangerous Scorpion in Brazil

There are approximately 160 species of scorpions in Brazil, but only some pose a real risk to human health. The most dangerous is the Tityus serrulatus, popularly called the yellow scorpion.

Characteristics of the Yellow Scorpion

  • Yellowish colour
  • Measures between 6 and 7 centimetres
  • Responsible for the vast majority of serious cases and deaths in the country
  • Does not live only in the countryside: it is an urban animal par excellence

Where the Yellow Scorpion Hides

  • Rubble
  • Piles of brick
  • Stacked cardboard
  • Drains
  • Wall cavities
  • Clothes left on the floor
  • Shoes
  • Towels

Other Dangerous Species

Other species can also sting and cause serious reactions:

  • Tityus bahiensis — black scorpion
  • Tityus stigmurus — more common in the Northeast

Important rule: every scorpion sting, regardless of species, deserves immediate medical attention.

What the Venom Does to Your Body

Scorpion venom is a mixture of highly active proteins, called neurotoxins. They act mainly on the nervous system, forcing nerves to fire signals in an uncontrolled manner.

The result is a veritable storm in the body:

  • Heart accelerates
  • Salivary and sweat glands go into overdrive
  • Pancreas can be affected
  • Lungs can accumulate fluid
  • Heart, in the most serious cases, can go into failure

Everything starts quickly. Pain is the first sign and tends to be intense from the very first moment.

Recognising the Symptoms: From Mild to Severe

The symptoms of a scorpion sting are divided into local (those that stay at the bite site) and systemic (those that affect the entire body).

Local Symptoms

  • Immediate and intense pain
  • Burning or stinging sensation
  • Tingling (as if the area were "falling asleep")
  • Slight redness
  • In some cases, discrete swelling

Unlike a bee sting, very rarely is there significant oedema at the site.

Systemic Symptoms (Venom Spreading Through the Body)

  • Intense sweating
  • Nausea and vomiting
  • Excessive salivation
  • Agitation
  • Feeling of anxiety
  • Rapid heartbeat (tachycardia)
  • Elevated blood pressure
  • Tremors
  • Blurred vision
  • Difficulty swallowing

More Severe Cases (Especially in Children and Elderly People)

The evolution can be rapid towards:

  • Acute pulmonary oedema (lungs fill with fluid)
  • Shock
  • Seizures
  • Coma

Medical Classification of Severity

Doctors classify the scorpion accident into three degrees:

  • Mild degree: only pain and local tingling, with no symptoms in the rest of the body
  • Moderate degree: systemic symptoms present, but without serious organ compromise
  • Severe degree: signs of cardiovascular failure, pulmonary oedema, seizures or coma

This classification is made by the doctor during care and will directly determine the necessary treatment.

What to Do Immediately After the Sting

First and most important step: seek emergency care or an urgent care unit immediately, without wasting time.

Do not wait for symptoms to worsen. There is no effective home treatment against scorpion venom.

Correct Measures While Travelling to Receive Care

  • Keep the stung area elevated if possible
  • Apply a cold compress (not ice directly on the skin) to help relieve local pain
  • Drink water normally if you are not feeling nauseous
  • Rest

What MUST NEVER Be Done

  • Do not apply a tourniquet (that tied around the limb)
  • Do not cut or suck the bite site
  • Do not apply earth, coffee grounds, leaves or any household substance to the wound
  • Do not apply alcohol or any product directly to the stung skin
  • Do not give any home remedies on your own

These practices have no effect against the venom and can still cause infection or delay correct treatment.

Should You Take the Scorpion to the Hospital?

Whenever it is possible to capture the scorpion safely — that is, without putting anyone else at risk — take it to the medical appointment inside a closed container, such as a pot with a lid. This helps the doctor identify the species and better estimate the severity of the case.

However, never risk a second sting trying to capture the animal. If it is not safe, go to the appointment without it. The doctor will assess and treat based on the symptoms, regardless of whether they have the scorpion in hand or not.

If You Are Far from the Hospital

If you are in a rural area, far from a health service, the guidance is the same: seek medical care as quickly as possible.

Whilst you are travelling:

  • Keep the stung person at rest, preferably lying down
  • Stay with them constantly under continuous observation
  • Monitor their vital signs

If they start to:

  • Vomit
  • Experiencing difficulty breathing
  • Lose consciousness
  • Have seizures

Call SAMU (192) immediately and describe the situation. They can provide guidance remotely and activate the nearest service.

Do not waste time with alternatives: the antidote can only be applied in a hospital setting, by trained staff.

At the Hospital: What Tests Are Requested?

Medical care begins with a complete clinical assessment. Depending on the patient's condition, a series of tests can be requested to assess how the venom is affecting the organs.

Main Tests

  • Full blood count
  • Blood glucose — scorpion stings frequently cause elevated blood sugar
  • Electrolyte levels — sodium and potassium
  • Renal function — urea and creatinine
  • Amylase and lipase — to evaluate the pancreas, which can be affected
  • Muscle enzymes — such as creatine kinase
  • Electrocardiogram — to monitor the heart
  • Chest X-ray — in cases where pulmonary oedema is suspected
  • Arterial blood gas — in severe cases, to assess blood oxygenation

The paediatrician or clinician uses these tests together with the symptoms to define the degree of severity and, with this, the therapeutic approach.

The Antiscorpion Serum: How It Works and When It Is Indicated

The antidote against scorpion venom is the Antiscorpion Serum (SAE).

Production and Distribution

  • Produced mainly by the Butantan Institute (São Paulo) and the Ezequiel Dias Foundation (FUNED, Minas Gerais)
  • Distributed free of charge by the Unified Health System (SUS)
  • Should be available in public hospitals and emergency care units

How It Works

The serum is made from antibodies that neutralise the toxins of scorpion venom. It is applied directly into the vein, in a hospital setting, with the patient monitored.

Dosage

The amount of ampoules administered depends on the degree of severity of the case:

  • Moderate cases: around 3 ampoules
  • Severe cases: 6 or more ampoules, always according to the Ministry of Health protocol and the clinical judgment of the medical team

Mild Cases

In cases classified as mild, the serum is usually not necessary. Treatment is limited to pain control with analgesics and observation for a few hours to ensure the condition does not progress to moderate or severe.

Adverse Reactions to the Serum: What Can Happen

Like any biological product, antiscorpion serum can cause adverse reactions in some patients.

Most Common Reactions

  • Urticaria — those reddish patches with itching on the skin
  • Generalised itching
  • Swelling in some parts of the body

Rare But Serious Reactions

In rarer cases, an anaphylactic reaction can occur — a severe and rapidly onset allergic response, with:

  • Drop in blood pressure
  • Difficulty breathing
  • Circulatory collapse

Why the Serum Is Still Necessary

The serum is always applied within the hospital, with the patient monitored and with all the necessary infrastructure to treat any reactions. The medical team is prepared for this.

In higher-risk situations, a pre-medication can be given to reduce the chance of an allergic reaction. The benefits of the serum in moderate and severe cases far outweigh the risks of adverse reactions.

Who Is at Greater Risk: Groups Requiring Special Attention

Small Children

Children under seven years of age are the most vulnerable to scorpion stings.

This is because the smaller body weight means that the amount of venom is proportionally much greater in relation to body size, making the progression to severe cases much faster.

Any child stung by a scorpion should be taken to the emergency room immediately, regardless of whether initial symptoms seem mild.

Elderly People

Elderly people, especially those with pre-existing cardiovascular disease, also have a higher risk of developing severe conditions. A heart already weakened tends to respond with greater intensity to the stress that the venom places on the circulatory system.

Other Risk Groups

  • Pregnant women
  • Immunocompromised individuals

All these groups deserve extra attention and immediate care.

How to Prevent Scorpion Accidents at Home

Prevention begins with knowledge of the scorpion's habitat.

Cleaning and Organisation

  • Keep the house clean and free of clutter
  • Avoid cardboard, old tiles or construction material in the yard
  • Keep rubbish in closed containers

Physical Protection

  • Seal cracks and fissures in walls
  • Place screens on drains and storm drains

Care with Clothing and Footwear

  • Use plastic bags to store clothes and footwear that remain still for long periods
  • Check before use
  • Shake clothes and towels before wearing

When Dealing with Risk Areas

  • Wear gloves when handling rubble or gardening

Cockroach Control

  • Keep the house clean, as the scorpion follows the path of cockroaches, which are its preferred food

If You Find a Scorpion in Your House

  • Do not step on it: this can cause a reflex sting
  • Use a container and a spoon to capture it
  • Contact your municipality's Animal Disease Control office for proper disposal

In Summary: What You Need to Know

  • Scorpion sting is a medical emergency. Go to the emergency room immediately, even if initial symptoms seem mild
  • Do not waste time with home remedies or tourniquets
  • If possible, take the scorpion in a closed container
  • Children should be taken with maximum urgency
  • The antidote is called Antiscorpion Serum and is available free of charge through the SUS
  • When treatment is provided in time, it is highly effective and saves lives

This content is for informational purposes only and does not replace medical consultation. Seek medical care in case of scorpion sting.

Dr. Rebeca Soares Andrade
CRM-GO 39335