Fire coral envenomation
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Background
- Location is worldwide (excluding Hawaii) in reefs & shallow waters.[1]
- White to yellow-green appearance that are fixed to rocks and coral.[2]
- They possess tentacles that extend upward & are roughly 2m in length.[3]
- Fire corals (Millepora) are a genus of colonial marine organisms that exhibit physical characteristics similar to that of coral. The name coral is somewhat misleading, as fire corals are not true corals but are instead more closely related to Hydra and other hydrozoans, making them hydrocorals.
Nematocyst Mechanism
- Physical contact or osmotic gradient causes discharge of nematocysts
- A spring loaded venom delivery system
- Once opened, a nematocyst releases all of its contained venom
Clinical Features
- Contact with tentacles causes painful, urticarial lesions that may become hemorrhagic and ulcerate.[4]
- Symptoms can last up to 72 hours with skin hyperpigmentation that can last for several weeks.[5]
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
Workup
- Typically not required
Diagnosis
- Typically clinical
Management
- Pain is best managed with vinegar[6]
- Steroid cream and oral antihistamines can be used for mild urticaria.[7]
- If severe, oral steroids may be warranted.[8]
Disposition
- If hemodynamically stable, patient may be discharged home
See Also
References
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.
- ↑ Hauglid, Christopher, DO, et al. “EMERGEN-SEA MEDICINE: An Overview of Sea Urchins, Coral, Starfish, and More.” ACEP Now, vol. 40, no. 7, 2021, pp. 8–9.