Ischemic stroke in a 4 year child resulting from scorpion envenomation: A case report from Nepal.
Introduction
The scorpion sting is one of the most go to forms of envenomation in countries with tropical climates. There are a variety of scorpions, and some of them have venom that could be detrimental to human beings. Non-fatal symptoms are common, which include pain, burning sensation, and change in color of the skin. Scorpion venom contains neurotoxins, which trigger the body to release endogenous catecholamines and acetylcholine. Systemic envenomation invites autonomic instability with a wide range of manifestations, including cardiovascular (hypertension, tachycardia, arrhythmias, myocarditis, distributive and cardiogenic shock), pulmonary (acute respiratory distress syndrome, pulmonary edema, atelectasis, bronchospasm), acute renal dysfunction, neurological emergencies (seizures, ischemia, hemorrhage, and rarely demyelination), and disseminated intravascular coagulation. A sympathetic storm may or may not follow the initial parasympathetic overdominance phase, which displays emesis, abdominal pain, excessive salivation, bradycardia, and pupillary constriction. Cerebrovascular injury in systemic envenomations is considered very odd. Globally, it has been documented in only 2% to 5% of cases of scorpionism. 1,2,3,4,5,6,7,8
We hereby present the case of a 4 year old child with features consistent with autonomic storm following scorpion sting who later developed left sided ischemic stroke. However,he lacked features of defibrination syndrome and myocarditis. Therefore, the most speculated cause of stroke in our patient was presumed to be the autonomic storm and toxin associated vasculitis.
Sunil Bhatta, Pusp Awasthi. Ischemic stroke in a 4 year child resulting from scorpion envenomation: A case report from Nepal. Authorea. March 10, 2024. DOI: 10.22541/au.171007567.71523940/v1
