Acute respiratory failure following scorpion stings: Anaphylaxis or severe systemic envenomation?

Scorpion stings can cause a range of reactions which includes severe systemic envenomation resulting in respiratory failure, cardiovascular collapse, and severe neurologic complications. Patients with allergies to scorpion venom or allergies to bee and ant venom can have anaphylactic reactions following scorpion stings. We report a patient who developed severe respiratory distress following 2-3 scorpion stings on her face. She required an emergency cricothyroidotomy and prolonged hospitalization, related in part to underlying comorbidity. Physicians caring for patients following scorpion stings need to remember that these patients can have severe reactions to the venom, including anaphylactic reactions. The initial management likely involves respiratory and cardiac resuscitation. These patients may have a very difficult intubation and require an emergency surgical airway