A Case Report of Acute Ischemic Stroke Following Scorpion Sting: That’s Too Coincidental To Be Coincidence

Abstract

Introduction: Envenomation is common in developing countries, with more than 2600 reports of mortality following scorpion envenomations being reported per year. It also can produce a variety of clinical presentations, from minimal to life threatening, including neurological disorder. There are some brain ischaemic infarct cases following scorpion bite reported in india and some african country but there is no official data reported in indonesia

Case Presentation: A 56-year-old female patient with controlled Diabetic who was stung by a small yellowish white scorpion in the morning on the tip of her right finger felt pain and found a small redness bump on it. She also vomited twice and got epigastric pain. In the afternoon, she came to ED with chief complain of spinning sensation, weakness of her left arm and slurred speech when getting up from bed. This symptom are appropriate to the 3 stages of scorpion envenomation.

Discussion: The neurological examination was appropriate with lesions in the sub cortex and spinning dizziness suggesting  cerebellum lesion. The results of a head CT also showed signs of infarction in the pons which direct us to multiple site infarct as what has been reported that infarct in scorpion envenomation tend to be multiple and predominant in parietooccipital, cerebellar and capsuloganglionic regions.

Conclusion: This case report is meant to remind us regarding mortality and morbidity caused by scorpion sting which tend to be underestimated in Indonesia. We recommend to observe (at least for 12 hours) the scorpion sting patient who show symptoms of envenomation.