Scorpion bite-induced ischaemic stroke

Abstract

We report a 54-year-old woman with scorpion bite. After 3 hours of admission, the patient developed sudden onset tachycardia with hypotension. Cardiac evaluation showed raised creatine kinase MB isoenzyme was elevated; ECG and two-dimensional echocardiography findings were suggestive of myocarditis. Subsequently, she developed transient ventricular tachycardia before developing abrupt onset, right hemiplegia, global aphasia and progressive worsening of sensorium 12 hours after the bite. MRI of brain revealed massive left middle cerebral artery (MCA) territory infarct. The magnetic resonance angiography showed non-visualisation of left internal carotid artery (ICA) and MCA. Coagulation parameters were normal. Sudden complete occlusion of left ICA was probably secondary to cardioembolic phenomenon leading to massive infarct. Despite aggressive medical and supportive measures, she clinically worsened rapidly to Glasgow Coma Scale of 3/15 over next 6 hours and succumbed to her illness the next day.

Ischemic stroke in a 4 year child resulting from scorpion envenomation: A case report from Nepal.

“…They can be summarized as briefly due sympathetic storm, myocarditis (left ventricular systolic dysfunction due to myocarditis, causing stagnation of blood and subsequent thromboembolism), venom vasculitis, and defibrination syndrome. 6,7…”

“…Furthermore, medical professionals working in environments where scorpion stings are commonly reported should be aware of the wide range of clinical toxidrome associated with envenomation. 1,2,3,4,5,6,7,8…”

“…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.…”

Biochemical and Proteomic Characterization, and Pharmacological Insights of Indian Red Scorpion Venom Toxins

“…As mentioned above, catecholamines released following scorpion envenomation can play a crucial role in initiating cardiac disorder by activating the β-receptors in the heart. The continuous release of endogenous and exogenous catecholamines post Indian scorpion sting causes an increase in spontaneous diastolic depolarization on cardiac fibers, which elevates the heart rate that leads to tachycardia or tachyarrhythmia ( Reddy et al, 2017 ).…”

Transient Ischemic Attack After Scorpion Sting: A Case Report

“…Ischemic cerebral infarction due to scorpion sting is very rare. The clinical presentation of scorpion sting poisoning can be elaborated with respiratory distress associated with arterial hypertension, cardiac arrhythmias, myocarditis, or pulmonary edema (1,2). These symptoms occur as a result of the release of catecholamines in the circulation or due to the direct cardiac toxicity of the venom.…”