Stingray injury

Background

Common stingray (Dasyatis pastinaca)
A stingray's stinger (ruler in cm)
  • Stinger punctures skin to introduce heat-labile venom
  • Generally causes local symptoms without systemic effects
  • Often occurs when swimmers accidentally step on stingray in shallow water. Can be avoided by shuffling feet along bottom.

Clinical Features

Treatment of stingray injury with hot water.

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

  • Clinical diagnosis
  • Consider x-ray to evaluate for retained foreign body (stinger)

Management

  • Immediately immerse wound in hot water (45°C for 30-90min) [1]
    • Hot water is thought to denature the thermolabile venom
  • Supportive care
  • Remove spines and stinger, if visible
  • XR for evaluation of foreign bodies
  • Tetanus prophylaxis
  • Prophylactic antibiotics are controversial - if used, give ciprofloxacin to cover Vibrio vulnificus

Disposition

  • Discharge

See Also

External Links

References

  1. Atkinson PRT. Is hot water immersion an effective treatment for marine envenomation? Emergency Medicine Journal. 2006;23(7):503–508. doi:10.1136/emj.2005.028456.