Cone shell envenomation: Difference between revisions
 
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==Background==
==Background==
[[File:Textile cone.jpg|frameless|right|A dangerous cone to handle, Conus textile.]]
*Also known as cone snails
*Conus genus includes 800 species<ref>Kohn AJ. Conus Envenomation of Humans: In Fact and Fiction. Toxins (Basel). 2018;11(1):10. Published 2018 Dec 27. doi:10.3390/toxins11010010</ref>
*Conus genus includes 800 species<ref>Kohn AJ. Conus Envenomation of Humans: In Fact and Fiction. Toxins (Basel). 2018;11(1):10. Published 2018 Dec 27. doi:10.3390/toxins11010010</ref>
*Human fatality rates 15-75%<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>
*Human fatality rates 15-75%<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>
*Neurotoxin, paralytic venoms
*Neurotoxin, paralytic venoms with a variety of neuromuscular effects through glutamate, adrenergic, serotonin, and cholinergic pathways
[[File:Textile cone.jpg|frameless|right|A dangerous cone to handle, Conus textile.]]<ref>Wikipedia contributors. Cone snail. Wikipedia, The Free Encyclopedia. January 2, 2021, 23:47 UTC. Available at: https://en.wikipedia.org/w/index.php?title=Cone_snail&oldid=997936825. Accessed January 5, 2021.</ref>


==Clinical Features==
==Clinical Features==
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*Death can occur in 1-5 hours
*Death can occur in 1-5 hours


==Differential Diagnosis==
==Differential Diagnosis<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>==
<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>
*[[Anaphylaxis]]
*Anaphylaxis
 
*Cnidaria envenomation
{{Marine envenomation DDX}}
*Sea snake envenomation
*Shellfish envenomation


==Evaluation==
==Evaluation==
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===Diagnosis===
===Diagnosis===
*Clinical history


==Management==
==Management==
*No antivenom available
''No antivenom available''
*ABC's
*ABC's
*Prepare for mechanical ventilation with supportive care
*Hot water (40C-50C) may provide pain relief based on anecdotal reports
*Most patients will develop a chronic wound at the envenomnation site with ulceration that often requires persistent care.
*Prepare for [[mechanical ventilation]] with supportive care
*Most patients will develop a chronic wound at the envenomation site with ulceration that often requires persistent care.


==Disposition==
==Disposition==
 
*ICU if intubated
*No clear information on length of observation


==See Also==
==See Also==
 
*[[Marine toxins, envenomations, and bites]]


==External Links==
==External Links==
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==References==
==References==
<references/>
<references/>
[[Category:Environmental]]
[[Category:Dermatology]]

Latest revision as of 14:37, 25 November 2021

Background

A dangerous cone to handle, Conus textile.
  • Also known as cone snails
  • Conus genus includes 800 species[1]
  • Human fatality rates 15-75%[2]
  • Neurotoxin, paralytic venoms with a variety of neuromuscular effects through glutamate, adrenergic, serotonin, and cholinergic pathways

Clinical Features

  • Sharp prick to extreme pain
  • Envenomation site: numbness, swelling, ischemia, cyanosis
  • Systemic: weakness, sweating, visual changes, muscle paralysis, respiratory failure, cardiovascular collapse, coma
  • Death can occur in 1-5 hours

Differential Diagnosis[3]

Marine toxins, envenomations, and bites

Evaluation

Workup

  • Due to systemic symptoms CMP, Chest X-ray, EKG are reasonable[4]

Diagnosis

  • Clinical history

Management

No antivenom available

  • ABC's
  • Hot water (40C-50C) may provide pain relief based on anecdotal reports
  • Prepare for mechanical ventilation with supportive care
  • Most patients will develop a chronic wound at the envenomation site with ulceration that often requires persistent care.

Disposition

  • ICU if intubated
  • No clear information on length of observation

See Also

External Links

References

  1. ↑ Kohn AJ. Conus Envenomation of Humans: In Fact and Fiction. Toxins (Basel). 2018;11(1):10. Published 2018 Dec 27. doi:10.3390/toxins11010010
  2. ↑ Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/
  3. ↑ Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/
  4. ↑ Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/
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