Phylum porifera

Background

• Also known as "sponges"

Life and Habitat

• Approximately 5000 species of sponge
• Generally stationary and attach to see floor or coral beds

Relevant species

• Most common Tedania ignis (Hawaiian or West Indian fire sponge)
  • Found in Florida and Hawaii
• Fibula nolitangere (poison bun sponge)
• Microciona prolifera (red moss sponge)

Clinical Features

Left: eczema-like plaques on the hand after known marinesponge exposure. Right: disseminated excoriated papules in a swimmer after diving in a lake in the Amazon region.

• Symptoms caused by contact with sponge
• Reaction appears between 10 minutes and a few hours of contact
• Starts with pruritus and burning
• Maculopapular rash with local edema, bullae formation, paresthesias and possible joint swelling
  • When large areas of skin are involved, patients can have fever, malaise, dizziness, nausea, muscle cramps
• Mild reactions resolve in 3-7 days
• Pruritic dermatitis and rarely erythema multiforme or anaphylactoid reaction

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
  • Stingray injury
• Venomous fish
  • Cone shell
  • Lionfish
  • Sea urchins
  • Crown-of-Thorns Starfish
  • Stonefish
  • Other: Catfish, zebrafish, scorpion fish
• Nematocysts
  • Coral reef
  • Fire coral
  • Jellyfish (Cnidaria)
    • Box jellyfish
      • Irukandji syndrome
    • Sea wasp
  • Portuguese man-of-war
  • Sea anemones
  • Seabather's eruption
• Phylum porifera (sponges)
• Bites
  • Alligator and crocodile attacks
  • Octopus bite
  • Shark bite
• Infections
  • Vibrio species in saltwater
  • Aeromonas species in freshwater

Management

• Gently dry skin
• Attempt to remove small spicules embedded in skin
  • May use adhesive tape
• Use 5% acetic acid (vinegar) soaks to affected area 10-30 minutes 3-4 times daily
  • If unavailable may use 40-70% isopropyl alcohol
• Topical steroids may relieve secondary inflammation
• Oral steroids for erythema multiforme or dyshidrotic eczema
• Tetanus prophylaxis
• Close follow up for wound checks to monitor for infection

Disposition

• If hemodynamically stable & pain controlled, patient may be discharged home

See Also

• Marine toxins and envenomations

References

• Auerbach PS, DiTullio AE. Envenomation by Aquatic Invertebrates. In Auerbach PS, Cushing TA, Harris NS. Auerbach’s Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017: 1679 – 1682.