Lionfish envenomation

Background

Lionfish.jpg
  • Number of camouflaged bottom-dwelling fish fish species within family Scorpaenidae, mostly found in the Indo-Pacific
  • Also called zebrafish, firefish, turkeyfish, tastyfish or butterfly-cod
  • Fins have spine connected to venom glands which inject venom when agitated

Clinical Features

Edema and erythema in the right hand of a patient two hours after puncture in the middle finger.
Edema and erythema on the index and medium fingers of the right hand after sting to index finger.
  • Local erythema, ecchymosis, swelling
  • Intense, sharp pain
  • Symptoms peak at 60-90 minutes
  • Duration: 1-2 days

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

  • Clinical diagnosis, no specific testing available
  • Consider radiography as retained foreign bodies are common[1]

Management

  • Clean wound, update tetanus, remove retained tissue
  • One fifth of wounds develop local infection, but prophylactic antibiotics remain controversial [2]
  • Immerse extremity in hot water (45 C) for 30-60 minutes

Disposition

See Also

References

  1. *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.
  2. *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.