Case history/examination
A 4 year child presented to our emergency department with features of vomiting, abdominal pain, and decreased sensorium following a complaint of pain and noticeable swelling in the right great toe. After a sleep of approximately 10 hours, the child woke up in the morning complaining of severe pain in the right lower extremity. The mother of the child noticed swelling in the right great toe, and one of the family members noticed the scorpion on the floor of the room. They envisioned that the child was stung by the arthropod and rushed to our hospital emergency room.
The child presented to our emergency with features consistent with history. On arrival, the child was febrile, with a temperature of 100.8 degrees Fahrenheit, heart rate of 140/minute and blood pressure of 125/87 mm Hg. Thorough evaluation revealed that the child was drowsy with Glasgow Coma Scale (GCS) of 12 (E3V3M6) and was unable to move right extremity while giving a command and poking with painful stimuli. Deep tendon reflexes and tone were increased in right upper and lower extremities.