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Leiurus quinquestriatus
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Leiurus quinquestriatus  [ Original photo copyright © Dr Wolfgang Wuster ]
Family: Buthidae
Genus: Leiurus
Species: quinquestriatus
Subspecies: quinquestriatus , hebraeus
Common Names
Yellow Scorpion , Palestine yellow scorpion , "death stalker" , fivekeeled gold scorpion
Middle East + North Africa
Algeria, Chad, Egypt, Ethiopia, Israel, Jordan, Lebanon, Libya, Mali, Niger, Saudi Arabia, Sudan, Syria, Tunisia, Yemen, Somalia
Taxonomy and Biology
Adult Length ( mm ): 60 mm
Base colour varies between yellowish to pale orange-brown. Carapace and tergites are yellowish brown with tergite VII the palest. Metasomal segments III and IV carinae are darker brown and segment V is usually dark or darker brown ( except at extreme anterior and posterior margins ) in adults ( black in young ). Legs are pale yellow.
Species Map
Small (Approx 20k) version
General: Venom Neurotoxins
Excitatory neurotoxins
General: Venom Myotoxins
Not present
General: Venom Procoagulants
Not present
General: Venom Anticoagulants
Not present
General: Venom Haemorrhagins
Not present
General: Venom Nephrotoxins
Not present
General: Venom Cardiotoxins
Possibly present
General: Venom Necrotoxins
Not present
General: Venom Other
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: >80%
General: Untreated Lethality Rate: 1-10%
General: Local Effects
Local pain & swelling
General: Local Necrosis
Does not occur, based on current clinical evidence
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, tachypnoea, respiratory distress, hypotension, dizziness, collapse or convulsions
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
Does not occur, based on current clinical evidence
General: Renal Damage
Does not occur, based on current clinical evidence
General: Cardiotoxicity
Common, cardiotoxicity is major clinical effect
General: Other
Does not occur, based on current clinical evidence
First Aid
Description: First aid for scorpion stings (in areas where potentially dangerous species may be found)
1. After ensuring the patient and onlookers are not at risk of further scorpion stings, the victim should be reassured and persuaded to lie down and remain still. Some may be terrified, fearing sudden death and, in this mood, they may behave irrationally or even hysterically, a situation made worse by the intense pain often suffered. The basis for reassurance is the fact that most scorpion stings prove non-lethal and the effectiveness of modern medical treatment.
2. The sting wound should not be tampered with in any way. Wiping it once with a damp cloth to remove surface venom is unlikely to do much harm (or good) but the wound must not be massaged.
3. Though unproven, there is anecdotal evidence suggesting the application of a cold pack to the sting area may reduce pain. At least in Mexico, there is also anecdotal evidence suggesting local suction may be beneficial.
3. All rings or other jewellery on the bitten limb, especially on fingers, should be removed, as they may act as tourniquets if swelling develops.
4. The bitten limb should be immobilised as effectively as possible using an extemporised splint or sling; if available, crepe bandaging of the splinted limb is an effective form of immobilisation.
5. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, for bites causing flaccid paralysis, including respiratory paralysis, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention.
6. Do not use Tourniquets, cut, suck or scarify the wound or apply chemicals or electric shock.
7. Avoid peroral intake, absolutely no alcohol. No sedatives outside hospital. If there will be considerable delay before reaching medical aid, measured in several hours to days, then give clear fluids by mouth to prevent dehydration.
8. If the offending scorpion has been killed it should be brought with the patient for identification.
9. The scorpion sting victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person (health station, dispensary, clinic or hospital). The bitten limb must not be exercised as muscular contraction will promote systemic absorption of venom. If no motor vehicle or boat is available, the patient can be carried on a stretcher or hurdle, on the pillion or crossbar of a bicycle or on someone's back.
10. Most traditional, and many of the more recently fashionable, first aid measures are useless and potentially dangerous. These include local cauterization, incision, excision, amputation, injection or instillation of compounds such as potassium permanganate, phenol (carbolic soap) and trypsin, application of electric shocks or ice (cryotherapy), use of traditional herbal, folk and other remedies including the ingestion of emetic plant products and parts of the snake, multiple incisions, tattooing and so on. The role of suction by mouth, vacuum pump or syringe, combined incision and suction ("venom-ex" apparatus) is uncertain.

Treatment Summary
Yellow scorpion envenoming is potentially severe, even lethal in children. All cases should be admitted for assessment. If there is systemic envenoming present, IV antivenom should be given urgently.
Key Diagnostic Features
Severe local pain, neuroexcitatory envenoming with pulmonary oedema & cardiotoxicity.
General Approach to Management
All cases should be treated as urgent & potentially lethal. Rapid assessment & commencement of treatment including appropriate antivenom (if indicated & available) is mandatory. Admit all cases.
Antivenom Therapy
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
1. Antivenom Code: IAfAVC01
Antivenom Name: Polyvalent Scorpion Antivenom
Manufacturer: National Antivenom and Vaccine Production Centre
Phone: ++966-1-252-0088 ext 45626, 45637.
Address: P.O. Box 22490
Riyadh 11426
Country: Saudi Arabia
2. Antivenom Code: IAfIPT01
Antivenom Name: Anti-scorpionic sera
Manufacturer: Institut Pasteur du Tunis
Phone: ++21-61-283022
Address: 13 Place Pasteur,
B.P. 74
1002 Tunis-Belvedere,
Country: Tunisia
3. Antivenom Code: IAfSPF04
Antivenom Name: Scorpifav
Manufacturer: Sanofi-Pasteur
Phone: +33 (0)4 37 37 01 00
Address: 2, Avenue Pont Pasteur, CEDEX 07, Lyon 69367
Country: France
4. Antivenom Code: IAfVAC03
Antivenom Name: Purified Polyvalent Anti-scorpion Serum
Manufacturer: VACSERA
Phone: (+20 2) 3761-1111
Address: 51 Wezaret El Zeraa St., Agouza, Giza, 22311
Country: Egypt
Leiurus quinquestriatus [ Original photo copyright © Dr Wolfgang Wuster ]
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Leiurus quinquestriatus female (Egypt) [ Original photo copyright © Eric Ythier ]
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Leiurus quinquestriatus male (Lybia) [ Original photo copyright © Eric Ythier ]
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Leiurus quinquestriatus couple (Egypt) [ Original photo copyright © Eric Ythier ]
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Leiurus quinquestriatus [ Original photo copyright © Dr Julian White ]
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