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<< Bites and Stings Snakes, Spiders, and Scorpions in the United States

Scorpions: Differential Diagnosis

Scorpion envenomation bears some clinical resemblance to black widow spider envenomation. However, unlike black widow spider bites, scorpion stings often cause intense local pain at the site of the envenomation. Additionally, black widow spider bites result in local sweating and possibly lymphangitis, unlike scorpion stings. Cardiac manifestations of myocarditis and dysrhythmias suggest consideration of myocardial infarction, infectious myocarditis, and other cardiac diseases. The neurological irritability, including rotatory eye movements, muscle fasciculations, and myoclonus, may suggest the possibility of seizures. Intoxication with cocaine, amphetamines, and other stimulants should be considered.31,90,93

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