Omullo FP. Successful management of third-trimester scorpion envenomation (Parabuthus maximus) in a resource-limited setting: A case report. World J Clin Cases 2026; 14(2): 114762 [DOI: 10.12998/wjcc.v14.i2.114762]
Corresponding Author of This Article
Felix Pius Omullo, MD, MBChB, Senior Researcher, Department of Medical Services, Equity Afya Limited, Kanaamkemer, Lodwar 399-30500, Turkana, Kenya. piuskirasia@gmail.com
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Obstetrics & Gynecology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 16, 2026 (publication date) through Jan 23, 2026
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World Journal of Clinical Cases
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2307-8960
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Omullo FP. Successful management of third-trimester scorpion envenomation (Parabuthus maximus) in a resource-limited setting: A case report. World J Clin Cases 2026; 14(2): 114762 [DOI: 10.12998/wjcc.v14.i2.114762]
World J Clin Cases. Jan 16, 2026; 14(2): 114762 Published online Jan 16, 2026. doi: 10.12998/wjcc.v14.i2.114762
Successful management of third-trimester scorpion envenomation (Parabuthus maximus) in a resource-limited setting: A case report
Felix Pius Omullo
Felix Pius Omullo, Department of Medical Services, Equity Afya Limited, Lodwar 399-30500, Turkana, Kenya
Author contributions: Omullo FP managed the patient, collected the data, analyzed the clinical information, and wrote the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All author declares no conflicts of interest related to this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Felix Pius Omullo, MD, MBChB, Senior Researcher, Department of Medical Services, Equity Afya Limited, Kanaamkemer, Lodwar 399-30500, Turkana, Kenya. piuskirasia@gmail.com
Received: September 28, 2025 Revised: November 11, 2025 Accepted: December 24, 2025 Published online: January 16, 2026 Processing time: 110 Days and 17.5 Hours
Abstract
BACKGROUND
Scorpion envenomation in pregnancy is a rare but potentially fatal obstetric emergency, with limited evidence on optimal management and antivenom safety. Neurotoxic venom induces autonomic storms, threatening maternal cardiovascular stability and uteroplacental perfusion, which can lead to fetal distress or demise.
CASE SUMMARY
A 31-year-old gravida 4, para 3 woman at 36 weeks’ gestation presented 30 minutes after a confirmed Parabuthus maximus sting to her right foot. She manifested systemic envenomation, including agitation, profuse sweating, tachycardia (142 bpm), and hypertension (168/102 mmHg). Cardiotocography revealed fetal tachycardia (175-180 bpm). A multidisciplinary team initiated intravenous morphine, midazolam, and species-specific antivenom (South African Vaccine Producers Polyvalent Scorpion Antivenom), resulting in the resolution of maternal and fetal symptoms within 12 hours. Critically, antivenom was administered within 40 minutes of the sting, which likely contributed to the rapid reversal of the catecholamine surge. A key factor enabling this rapid and targeted response was the patient’s action of capturing the scorpion, allowing for precise species identification. The pregnancy progressed uneventfully to term, culminating in an uncomplicated vaginal delivery of a healthy infant.
CONCLUSION
This case illustrates that scorpion envenomation in late pregnancy poses a dual threat to both maternal and fetal well-being. Prompt recognition, continuous fetal monitoring, and the very early administration of antivenom-buttressed by multidisciplinary care-can avert catastrophic outcomes. This case provides supporting evidence that antivenom can be safe and effective during the third trimester, even in resource-constrained environments. Public education on safe first aid, including bringing the scorpion for identification, is essential.
Core Tip: Scorpion envenomation in pregnancy triggers a dangerous autonomic storm threatening both mother and fetus. We present a successful case of a multigravida at 36 weeks who developed maternal hypertension/tachycardia and fetal tachycardia after a sting by Parabuthus maximus. This case highlights three critical lessons: (1) Scorpion stings are an obstetric emergency requiring immediate fetal monitoring; (2) Early administration of antivenom is a safe and effective definitive treatment in the third trimester and rapidly reverses both maternal and fetal distress; and (3) A coordinated response between obstetrics, toxicology, and critical care is essential to prevent catastrophic outcomes like placental abruption or fetal demise.
