Scorpion envenoming caused by Tityus cf. silvestris evolving with severe muscle spasms in the Brazilian Amazon

• We report a severe envenoming caused by Tityus cf. silvestris in the Brazilian Amazon.
• The case evolved with severe muscle spasms requiring intensive care unit admission.
• Neurological symptoms persisted even days after antivenom therapy.
• After 9 days of close monitoring, the patient evolved favourably and was discharged without sequelae.

Scorpion stings are a public health problem in the Brazilian Amazon. However, detailed clinical characterization with the proper animal identification is scarce. Here we report a confirmed case of envenoming by Tityus cf. silvestris in the Brazilian Amazon. The case evolved with generalized muscle spasms and was treated with antivenom and supportive therapy, requiring intensive care unit admission. The patient evolved favourably and was discharged after 9 days of hospitalization.