Acute Transverse Myelitis and Pulmonary Thromboembolism Following Scorpion Envenomation: A Rare Case Report.

Scorpion envenomation is common in India but rarely leads to neurovascular complications. We present a rare case of a 72-year-old male who developed acute transverse myelitis, subarachnoid hemorrhage, and pulmonary thromboembolism following a scorpion sting. The patient presented with sudden-onset paraparesis. Magnetic resonance imaging (MRI) of the spine revealed longitudinal hyperintensity from T5 to T12, suggestive of transverse myelitis, along with evidence of spinal subarachnoid hemorrhage. Computed tomography (CT) pulmonary angiography confirmed bilateral pulmonary thromboembolism. Cerebrospinal fluid analysis showed a hemorrhagic tap with elevated protein and lactate dehydrogenase (LDH), but no infectious or malignant cells. Neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein (MOG) antibodies were negative. Nerve conduction studies showed bilateral sensorimotor axonal polyneuropathy. The patient was treated with corticosteroids and anticoagulants and showed gradual improvement. This case underscores the systemic toxicity of scorpion venom and highlights the importance of early recognition and multidisciplinary management of rare neurovascular complications.