Nematocysts: Difference between revisions
| Line 16: | Line 16: | ||
==Management== | ==Management== | ||
* | *Remove tentacles and nematocysts | ||
* | *Hot water immersion | ||
** | |||
* | *Consider topical lidocaine | ||
* | *Consider oral or parenteral analgesia for severe pain | ||
*Acetic Acid may inhibit or trigger nematocyst discharge and thereby increase or decrease pain depending on species | |||
*'''Avoid urine, ethanol, ammonia''' | |||
*'''Avoid fresh or tap water since it causes nematocyst discharge via the osmotic gradient''' | *'''Avoid fresh or tap water since it causes nematocyst discharge via the osmotic gradient''' | ||
*'''Symptomatic treatment for Irukandji syndrome''' | |||
*'''Antivenom is available for severe box-jellyfish sting''' | *'''Antivenom is available for severe box-jellyfish sting''' | ||
Revision as of 17:42, 19 August 2016
Mechanism
- Jellyfish; Box Jelly is most deadly
- Most toxic: Australia and other Indo-Pacific waters
- Physical contact or osmotic gradient causes discharge of neamtocysts
- A spring loaded venom delivery system
Clinical Features
- Isolated stinging
- Severe
- Respiratory paralysis, cardiovascular collapse, limb paralysis and death
- Irukandji syndrome - myalgias, back, chest, abdominal pain, nausea, vomiting, diaphoresis, hypertension, tachycardia, hypertension, myocardial injury, pulmonary edema
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
Management
- Remove tentacles and nematocysts
- Hot water immersion
- Consider topical lidocaine
- Consider oral or parenteral analgesia for severe pain
- Acetic Acid may inhibit or trigger nematocyst discharge and thereby increase or decrease pain depending on species
- Avoid urine, ethanol, ammonia
- Avoid fresh or tap water since it causes nematocyst discharge via the osmotic gradient
- Symptomatic treatment for Irukandji syndrome
- Antivenom is available for severe box-jellyfish sting