{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:18:53Z","timestamp":1767611933545,"version":"3.43.0"},"reference-count":26,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Acute heart failure, presenting as either cardiogenic shock or pulmonary edema, is the main cause of mortality because of scorpion envenomation (SE) in many tropical and subtropical parts of the world. Standard heart failure treatment, including inotropes and diuretics to treat cardiogenic shock and pulmonary edema, was used in most studies. However, the role of the inotrope levosimendan in the treatment of cardiogenic shock complicated by pulmonary edema and renal impairment after SE has rarely been reported, to the best of our knowledge. Here, we report this case of severe SE complicated by cardiogenic shock and pulmonary edema successfully managed with levosimendan in a 4-year-old patient. As a consequence, the use of this inotropic drug seems to be beneficial in severe cases of SE complicated by severe cardiogenic shock and not stabilized by the usually used inotropic and vasopressor agents (dobutamine and noradrenaline). Further studies are needed to confirm the usefulness of levosimendan in cardiogenic shock related to severe SE.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0020","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:25:56Z","timestamp":1748352356000},"page":"464-468","source":"Crossref","is-referenced-by-count":2,"title":["Intravenous Levosimendan for Acute Heart Failure with Renal Impairment Following Severe Scorpion Envenomation: Case Report and Literature Review"],"prefix":"10.4269","volume":"113","author":[{"given":"Karama","family":"Bouchaala","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mabrouk","family":"Bahloul","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amina","family":"Hadded","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oussama","family":"Haddar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hedi Chaker University Hospital, Sfax University, Sfax, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chokri Ben","family":"Hamida","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Toxicol (Phila)","first-page":"511","article-title":"Scorpion-related cardiomyopathy: Clinical characteristics, pathophysiology, and treatment","volume":"53","author":"Abroug","year":"2015"},{"key":"b2","series-title":"Intensive Care Med","first-page":"461","article-title":"Evidence of myocardial ischemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study","volume":"30","author":"Bahloul","year":"2004"},{"key":"b3","series-title":"Int J Cardiol","first-page":"86","article-title":"Pulmonary edema following scorpion envenomation: Mechanisms, clinical manifestations, diagnosis and treatment","volume":"162","author":"Bahloul","year":"2013"},{"key":"b4","series-title":"Arq Bras Cardiol","first-page":"444","article-title":"Assessment of myocardial perfusion and function in victims of scorpion envenomation using gated-SPECT","volume":"94","author":"Figueiredo","year":"2010"},{"key":"b5","series-title":"World J Cardiol","first-page":"33","article-title":"Takotsubo cardiomyopathy following envenomation: An updated review","volume":"15","author":"Mishra","year":"2023"},{"key":"b6","series-title":"Chest","first-page":"748","article-title":"Dobutamine in severe scorpion envenomation: Effects on standard hemodynamics, right ventricular performance, and tissue oxygenation","volume":"116","author":"Elatrous","year":"1999"},{"key":"b7","series-title":"Med Sci Monit","first-page":"BR71","article-title":"Beneficial effects of high dobutamine doses on hemodynamic perturbations induced by Buthus occitanus tunetanus venom in rats","volume":"15","author":"Hakim","year":"2009"},{"key":"b8","series-title":"Toxicon","first-page":"54","article-title":"Dobutamine in the treatment of severe scorpion envenoming","volume":"182","author":"Bouaziz","year":"2020"},{"key":"b9","series-title":"Cardiology in the Young (45th Annual Meeting of the Association for European Paediatric Cardiology, AEPC with Joint Sessions with the Japanese Society of Pediatric Cardiology and Cardiac Surgery)","first-page":"86","volume":"21","author":"Banille","year":"2011"},{"key":"b10","series-title":"EC Paediatr","first-page":"992","article-title":"Acute heart failure due to severe scorpionism and the usefulness of levosimendan in an infant. 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