Cone shell envenomation
Background
- aka 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
- Anaphylaxis
- Cnidaria envenomation
- Sea snake envenomation
- Shellfish envenomation
Evaluation
Workup
- Due to systemic symptoms CMP, Chest X-ray, EKG are reasonable[5]
Diagnosis
- Clinical history
Management
- No antivenom available
- ABC's
- Prepare for mechanical ventilation with supportive care
- Most patients will develop a chronic wound at the envenomnation site with ulceration that often requires persistent care.
- Hot water (40C-50C) may provide pain relief based on anecdotal reports
Disposition
- ICU if intubated
- No clear information on length of observation
See Also
External Links
References
- ↑ Kohn AJ. Conus Envenomation of Humans: In Fact and Fiction. Toxins (Basel). 2018;11(1):10. Published 2018 Dec 27. doi:10.3390/toxins11010010
- ↑ 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/
- ↑ 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.
- ↑ 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/
- ↑ 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/