When you live in the desert, a scorpion sting can happen at any time. And it can happen to anyone.
Just ask Asad "Sid" Patanwala, a clinical assistant professor with the University of Arizona College of Pharmacy and a pharmacist at the University of Arizona Medical Center, who was stung at his home in Oro Valley earlier this year.
"I was moving some rocks in the backyard when I felt a needle hit me," Patanwala said. "I never saw the scorpion before or after the sting."
Patanwala was wearing gloves but there was a hole in one of the glove's fingers. That's just where the scorpion stung him. He almost immediately began to feel some of the effects associated with scorpion stings.
"My finger started to tingle and get numb and then so did my arm," he said.
Eventually Patanwala developed pain in his arm, his face began twitching, and he was unable to see. It was at this point he knew he had to go to the emergency room at The University of Arizona Medical Center – University Campus. That also happens to be Patanwala's main work location.
Patanwala knew the hospital had an experimental scorpion antivenom that would treat his symptoms. At the time, the antivenom was still in the study phase and had not yet been approved by the U.S. Food and Drug Administration; people who received the drug had to sign a waiver to become a part of the study. (Rare Disease Therapeutics, the company that applied for FDA approval of the scorpion antivenom, was notified Aug. 3 that the antivenom was approved. The Arizona Poison and Drug Information Center and the VIPER Institute at the UA were key participants in the study that provided data needed for FDA review.)
Once at the hospital, he was treated by people he knew: toxicologist Mazda Shirazi, medical director of the Arizona Poison and Drug Information Center (which, coincidentally, is housed at and a part of Patanwala's employer, the College of Pharmacy); Ash Panchal, an attending physician; Chris Williams, a medical resident; and Karalea Jasiak, an emergency department pharmacy resident who works with Patanwala.
At this point, Patanwala had twitching all over his body, couldn't focus his eyes, couldn't walk, had a runny nose and was producing extra saliva.
"Usually this type of reaction is seen in children under the age of 5," Shirazi said. "It's not typical to see it in adults."
Scorpion stings can cause a number of different reactions in people, but two of the more common ones are noncardiogenic pulmonary edema and bronchorrhea. Noncardiogenic pulmonary edema symptoms are usually shortness of breath or rapid breathing. Bronchorrhea symptoms include increased secretions in the mouth, eyes and nose and coughing up watery mucus.
"The main problem you see in children is noncardiogenic pulmonary edema, but often the symptoms get confused with seizures," Shirazi said.
After Patanwala received the antivenom, he could tell it was working within 30 minutes. His sight returned first, then the twitching ceased, followed by the numbness going away.
"The numbness lingered in my fingers for a few days following, but everything turned out to be OK thanks to everyone involved," Patanwala said.
Patanwala now has his house sprayed once a month with insect killer to keep scorpions at bay.
"Spraying kills the insects and the scorpions feed on the insects," Shirazi said. "So keeping insects out of the home keeps scorpions out."
But Patanwala's experience shows that no matter how many safety precautions are taken, a scorpion sting can still happen to anyone. Ironically, he was stung due to his wife's urging that he do some yard work to prevent just the thing he experienced.
"She told me to move the flagstone in my backyard because our kids play out there and there could be scorpions among the rocks," he said. "She was right!"