Lionfish envenomation

Background

• From the Scorpaenidae familyof camouflaged bottom-dwelling fish
• Fins have spine connected to venom glands which inject venom when agitated

Clinical Features

• Intense, sharp pain
• Local erythema, ecchymosis, swelling
• Australian stonefish can cause systemic toxicity:
  • hypotension, tachycardia, arrhythmia, syncope, vomiting, and pulmonary edema
• Peak: 60-90 minutes
• Duration: 1-2 days

Evaluation

• Clinical diagnosis: no specific testing available

Management

• Clean wound, update tetanus, remove retained tissue
• Immerse extremity in hot water (45 C) for 30-60 minutes
• Stonefish envenomations with severe toxicity can be treated with antivenin obtained through poison control

References

• Olson, K. Poisoning and Drug Overdose Clinical Manual. 2004