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.