Biofactories Applied to Future Antivenom Production

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  Image Credit: By Ssiltane - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=52242648 Biofactories Applied to Future Antivenom Production Abstract Background: Accidents caused by the  Loxosceles laeta  spider constitute a health problem in South America. Envenomation can lead to severe systemic manifestations, eventually compromising the patient’s life. Most regional health authorities consider antivenom administration the basis of effective treatment in the most serious cases. The availability of spider venom is the primary bottleneck for antivenom production. Herein, we present a novel biotechnological approach, based on the expression of recombinant versions of the most relevant toxin in loxoscelism, sphingomyelinase D (SphD), in insect larvae ( Spodoptera frugiperda ).  Methods: We produced two versions of SphD: one conserving its biological activities (wtSphD) and a second alternative that was designed to be genetically detoxified (dSphD...

Pediatric Scorpion Envenomation in Tunisia: Epidemiology, Clinical Features, Therapeutic Management and Outcomes in a 14-Year Cohort Study

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Pediatric Scorpion Envenomation in Tunisia: Epidemiology, Clinical Features, Therapeutic Management and Outcomes in a 14-Year Cohort Study

Abstract

Background

Scorpion envenomation is a persistent public health concern in Tunisia, particularly in rural areas. Children are especially vulnerable due to low body weight and immature physiological systems.

Methods

We conducted a retrospective cohort study over a 14-year period (2011–2024) in the Pediatric Intensive Care Unit of Hedi Chaker University Hospital, Sfax, Tunisia. Children aged 0–14 years with confirmed scorpion envenomation were included. Epidemiological, clinical, biological, and outcome data were analyzed.

Results

Sixty-nine children were included, with a mean age of 4.6 years; two-thirds were under five years of age. Most cases occurred during summer and originated from rural areas. Systemic manifestations were present in 85.5% of patients. Moderate and severe envenomation were predominant, with 49.3% classified as Grade II and 39.1% as Grade III. Cardiac involvement was frequent, with elevated cardiac troponin observed in nearly half of cases and left ventricular dysfunction in more than one-third. Antivenom was administered in 88.4% of patients, and inotropic support was required in 25.9%. There were no fatalities; however, 18.5% of patients developed sequelae, mainly cardiac. Younger age, severe clinical presentation, seizures, respiratory distress, hyperglycemia, ventricular dysfunction, pulmonary edema, and delayed medical care (>2 hours) were significantly associated with adverse outcomes.

Conclusion

Pediatric scorpion envenomation often leads to systemic and cardiac complications. Early recognition and rapid management are critical to reducing morbidity.