Ischemic Stroke in a Child after a Probable Scorpion Sting

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  • 1 Policlínica Metropolitana, Caracas, Venezuela;
  • | 2 Tecnológico de Monterrey, Ciencias de la Salud y Escuela de Medicina, Guadalajara, Mexico;
  • | 3 Instituto Venezolano de Investigaciones Científicas, CBB, Caracas, Venezuela;
  • | 4 Medical College of Wisconsin, Milwaukee, Wisconsin;
  • | 5 University of Colorado, Anschutz Medical Center, Aurora, Colorado;
  • | 6 Hospital Infantil de México, Federico Gomez, Mexico City, Mexico;
  • | 7 Instituto Conmemorativo Gorgas de Estudios de la Salud, Investigador SNI-SENACYT, Ciudad de Panama, Panama

Scorpion stings are common emergencies in the tropics. Species-specific antivenom therapies are available. However, fatalities resulting from scorpion stings remain a public health concern in many settings. Children residing in rural towns and peri-urban areas represent the most vulnerable populations. Delays in the diagnosis of scorpion stings often occur as a result of the non-specific clinical presentations, which then lead to life-threatening complications. We report a 2-year-old Venezuelan boy presenting with acute pancreatitis and pulmonary edema without an identifiable cause 48 hours after his initial symptoms. We administered antivenom therapy when an undetected scorpion sting was suspected. Despite some initial clinical improvement with respect to his acute pancreatitis, pulmonary edema, and coagulation abnormalities, our patient experienced an ischemic stroke. Fortunately, our patient did demonstrate some neurological improvement. Although acute pancreatitis and pulmonary edema are known end-organ damage manifestations of the sting of Tityus in the Americas, our particular case illustrates the risk of ischemic stroke.

Author Notes

Address correspondence to Carlos Franco-Paredes, Division of Infectious Diseases, University of Colorado Denver School of Medicine, Anschutz Medical Campus, 12700 East 19th Ave., 11C01, Aurora, CO 80045, E-mail: carlos.franco-paredes@cuanschutz.eduor José Antonio Suárez, Instituto Conmemorativo Gorgas. Avenida Justo Arosemena, Panama, E-mail: jasuarez05@gmail.com.

Disclosure: L. N. has been a GSK employee since 2010. G. D’Suze has been the chief operating officer of SciMeDAn since 2018. C. Sevcik is the chief executive officer of SciMeDAn.

Authors’ addresses: Laura Naranjo, Policlínica Metropolitana, Caracas, Venezuela, E-mail: naranjo.laura1@gmail.com. Fernando Carrillo-Villaseñor, Tecnológico de Monterrey, Ciencias de la Salud y Escuela de Medicina, Guadalajara, Mexico, E-mail: carrillo_888@hotmail.com. Gina D’Suze and Carlos Sevcik, Instituto Venezolano de Investigaciones Científicas, CBB, Caracas, Venezuela, E-mails: gina.dsuze@gmail.com and csevcik@ivic.ve. Nathan Gundacker, Medical College of Wisconsin, Milwaukee, WI, E-mail: nathan.gundacker@va.gov. Amy Rao, University of Colorado, Anschutz Medical Center, Aurora, CO, E-mail: amy.rao@cuanschutz.edu. Carlos Franco-Paredes, University of Colorado, Anschutz Medical Center, Aurora, CO, and Hospital Infantil de México, Federico Gomez, Mexico City, Mexico, E-mail: carlos.franco-paredes@cuanschutz.edu. José Antonio Suárez, Instituto Conmemorativo Gorgas de Estudios de la Salud, Investigador SNI-SENACYT, Ciudad de Panama, Panama, E-mail: jasuarez05@gmail.com.

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