Lionfish envenomation: Difference between revisions
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==Background== | |||
[[File:Lionfish.jpg|thumb|]] | [[File:Lionfish.jpg|thumb|]] | ||
*Number of camouflaged bottom-dwelling fish fish species within family Scorpaenidae, mostly found in the Indo-Pacific | |||
* | *Also called zebrafish, firefish, turkeyfish, tastyfish or butterfly-cod | ||
*The fish have alternating brown, to orange and white stripes or spots. | |||
*They are common to home aquariums & account for the majority of spiny fish related calls to the poison control center in the U.S.<ref>Hauglid, C., Kiel, J., & Schmidt, A. (2021, April 23). Emergen-Sea Medicine: Overview of Marine Envenomations - Page 9 of 9. ACEP Now.https://www.acepnow.com/wp-content/uploads/2021/08/ACEP_August-2021.pdf</ref> | |||
*Fins have spine connected to venom glands which inject venom when agitated | *Fins have spine connected to venom glands which inject venom when agitated | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC4373524 40409 2015 7 Fig6 HTML.png|thumb|Edema and erythema in the right hand of a patient two hours after puncture in the middle finger.]] | |||
[[File:PMC4373524 40409 2015 7 Fig5 HTML.png|thumb|Edema and erythema on the index and medium fingers of the right hand after sting to index finger.]] | |||
*Local erythema, ecchymosis, swelling, & variable skin changes (e.g. pallor vs. erythema vs. cyanosis) <ref>Hauglid, C., Kiel, J., & Schmidt, A. (2021, April 23). Emergen-Sea Medicine: Overview of Marine Envenomations - Page 9 of 9. ACEP Now.https://www.acepnow.com/wp-content/uploads/2021/08/ACEP_August-2021.pdf</ref> | |||
*Intense, sharp pain | *Intense, sharp pain | ||
* | *Symptoms peak at 60-90 minutes | ||
*Duration: 1-2 days | *Duration: 1-2 days | ||
*Lesions can progress to hemorrhagic bullae with necrosis. | |||
*Systemic effects are similar to [[stonefish]]. | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 16: | Line 21: | ||
==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis | *Clinical diagnosis, no specific testing available | ||
*Consider radiography as retained foreign bodies are common<ref>*Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.</ref> | |||
==Management== | ==Management== | ||
*Clean wound, update tetanus, remove retained tissue | *Clean wound, update [[tetanus prophylaxis|tetanus]], remove retained tissue | ||
*One fifth of wounds develop local infection, but prophylactic antibiotics remain controversial <ref>*Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.</ref> | |||
*Immerse extremity in hot water (45 C) for 30-60 minutes | *Immerse extremity in hot water (45 C) for 30-60 minutes | ||
==Disposition== | ==Disposition== | ||
Patients should be observed for 6-12 hours. | |||
==See Also== | ==See Also== | ||
| Line 29: | Line 36: | ||
==References== | ==References== | ||
<references/> | |||
[[Category:Environmental]] | |||
[[Category:Toxicology]] | [[Category:Toxicology]] | ||
Latest revision as of 02:15, 1 September 2021
Background
- Number of camouflaged bottom-dwelling fish fish species within family Scorpaenidae, mostly found in the Indo-Pacific
- Also called zebrafish, firefish, turkeyfish, tastyfish or butterfly-cod
- The fish have alternating brown, to orange and white stripes or spots.
- They are common to home aquariums & account for the majority of spiny fish related calls to the poison control center in the U.S.[1]
- Fins have spine connected to venom glands which inject venom when agitated
Clinical Features
- Local erythema, ecchymosis, swelling, & variable skin changes (e.g. pallor vs. erythema vs. cyanosis) [2]
- Intense, sharp pain
- Symptoms peak at 60-90 minutes
- Duration: 1-2 days
- Lesions can progress to hemorrhagic bullae with necrosis.
- Systemic effects are similar to stonefish.
Differential Diagnosis
Marine toxins, envenomations, and bites
- Toxins
- Ciguatera
- Scombroid
- Tetrodotoxin (e.g. pufferfish)
- Shellfish poisoning
- Amnesic shellfish poisoning
- Diarrheal shellfish poisoning
- Neurotoxic shellfish poisoning
- Paralytic shellfish poisoning
- Stingers
- Venomous fish
- Cone shell
- Lionfish
- Sea urchins
- Crown-of-Thorns Starfish
- Stonefish
- Other: Catfish, zebrafish, scorpion fish
- Nematocysts
- Coral reef
- Fire coral
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Sea anemones
- Seabather's eruption
- Phylum porifera (sponges)
- Bites
- Infections
Evaluation
- Clinical diagnosis, no specific testing available
- Consider radiography as retained foreign bodies are common[3]
Management
- Clean wound, update tetanus, remove retained tissue
- One fifth of wounds develop local infection, but prophylactic antibiotics remain controversial [4]
- Immerse extremity in hot water (45 C) for 30-60 minutes
Disposition
Patients should be observed for 6-12 hours.
See Also
References
- ↑ Hauglid, C., Kiel, J., & Schmidt, A. (2021, April 23). Emergen-Sea Medicine: Overview of Marine Envenomations - Page 9 of 9. ACEP Now.https://www.acepnow.com/wp-content/uploads/2021/08/ACEP_August-2021.pdf
- ↑ Hauglid, C., Kiel, J., & Schmidt, A. (2021, April 23). Emergen-Sea Medicine: Overview of Marine Envenomations - Page 9 of 9. ACEP Now.https://www.acepnow.com/wp-content/uploads/2021/08/ACEP_August-2021.pdf
- ↑ *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.
- ↑ *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.