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Scorpion stings
Last reviewed: 04.07.2025
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Although all scorpions in North America sting, most are relatively harmless; stings usually cause only local pain with minimal swelling, and in some cases lymphangitis develops with enlargement of regional lymph nodes, as well as increased skin temperature and tenderness around the wound.
A notable exception is the bark scorpion (Centruroides sculpturatus, also known as C. exilicauda), found in Arizona, New Mexico, and the California side of the Colorado River. This species is venomous and can cause more serious problems. Initial symptoms include immediate pain and sometimes numbness or tingling in the area stung. There is usually no swelling, and skin changes are minor. Severe symptoms, usually seen in children, include:
- arousal (dysphoria);
- muscle spasms;
- abnormal or spontaneous movements of the head, neck and eyes;
- anxiety and excitement;
- sweating and hypersalivation.
In adults, tachycardia, hypertension, increased respiratory rate, weakness, muscle spasms, and fasciculations may predominate. Respiratory difficulties are rare in both age groups. C. sculpturatus bites can cause death in children (<6 cases per year) and in hypersensitive individuals.
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Diagnosis and treatment of scorpion bites
Diagnosis is usually based on the patient's history. However, it should be remembered that several species of scorpions kept by exotic pet owners in the United States (whose names are unfoundedly attributed to toxicity: yellow death stalker and black death scorpion) are similar in appearance to species that carry very dangerous venom. Stings by pet scorpions are rare, but if they occur, diagnosis based on the victim's story alone is unreliable. All stings should be treated as potentially dangerous until symptoms or lack of symptoms indicate otherwise.
Treatment of nonvenomous scorpion stings is nonspecific; ice applied to the wound and oral NSAIDs relieve pain. Treatment of venomous Centruroides stings includes rest, benzodiazepines for muscle spasms, intravenous medications to lower blood pressure, tranquilizers, and analgesics. Fasting is indicated for 8 to 12 hours after the sting. An antidote, available in the United States only in Arizona, should be given in an intensive care unit setting in all serious cases and in individuals not responding to supportive care, especially children. Information on the use and dosage of antidotes in the United States is available from regional poison control centers.