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BMJ Case Reports 2017; doi:10.1136/bcr-2017-221606
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Scorpion bite-induced ischaemic stroke

  1. Anirudda Deshpande3
  1. 1Department of Internal Medicine, Aditya Hospital, Warangal, Telangana, India
  2. 2Department of Medicine, Miraj Medical College, Miraj, Maharashtra, India
  3. 3Department of Neurology, Vinayaka Neuro Multispecialty Clinic, Warangal, India
  1. Correspondence to Dr Anirudda Deshpande, dr.anirudda.deshpande{at}gmail.com
  • Accepted 15 September 2017
  • Published 11 October 2017

Summary

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.

Footnotes

  • Contributors RRC and NB made substantial contributions to the conception and design of the work, acquisition, analysis and interpretation of the data. VK and AD were involved in drafting the work and revising it critically for important intellectual content. AD approved the final version to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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