Stages of Goyffon et al for Scorpion Envenomation

Goyffon et al described various stages of scorpion envenomation.

Stage	Severity	Clinical Features
I		immediate, intense pain that may fluctuate in intensity, lasting up to 24 hours
Ia	"benign"	isolated pain without generalized symptoms
Ib	moderate	pain plus generalized symptoms (agitation, sweating, nausea, feelings of being faint, alternating hypotension and hypertension
II	severe	systemic muscarinic symptoms (sweating, epigastric pain, vomiting, colics, diarrhea, priapism, hypotension, bradycardia, dyspnea), fever
III	extreme	cardiovascular collapse, pulmonary edema, bronchospasm, cyanosis, severe hyperthermia, cardiac arrhythmias, myocardial ischemia, death

where:

• Bahloul et al (see below) include coma and/or convulsions as clinical features of Stage III.

Laboratory findings:

(1) hyperglycemia

(2) leukocytosis up to 40,000 per µL

(3) elevated CK-MB and troponin with myocardial damage in Stage III

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