Sea anemone envenomation

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Background [1]

A selection of various sea anemones.
  • Located worldwide in deep and coastal waters
  • A type of Nematocyst
  • Often attached to coral or rock
  • Appearance consists of a single polyp with a cylindrical body
  • Their mouths are surrounded by cnidocyte-containing tentacles
    • Cnidocytes are cells containing one giant secretory organelle called a cnidocyst that can deliver a sting to other organisms

Venom Mechanism [2]

  • Anemone venom contains multiple enzymes including:
    • Cytolytic/hemolytic toxins
    • Neurotoxins
    • Cardiotoxins
    • Protease inhibitors

Nematocyst Mechanism

Nematocyst stages of discharge
  • 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 [3]

  • Erythema
  • Pruritis
  • Blisters
  • Skin changes can become permanent in the form of hyper/hypopigmentation and keloid formation
  • Fever
  • Chills
  • Myalgias
  • Syncope

Differential Diagnosis

Marine toxins, envenomations, and bites

Management [4]

  • Pain is managed with vinegar
  • Supportive care

Disposition

  • If the patient is hemodynamically stable and pain controlled, patient can be discharged home.

See Also

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.