Ver el código de «Cone shell envenomation»

==Background==
[[File:Textile cone.jpg|frameless|right|A dangerous cone to handle, Conus textile.]]
*Also known as cone snails
*Conus genus includes 800 species<ref>Kohn AJ. Conus Envenomation of Humans: In Fact and Fiction. Toxins (Basel). 2018;11(1):10. Published 2018 Dec 27. doi:10.3390/toxins11010010</ref>
*Human fatality rates 15-75%<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>
*Neurotoxin, paralytic venoms with a variety of neuromuscular effects through glutamate, adrenergic, serotonin, and cholinergic pathways

==Clinical Features==
*Sharp prick to extreme pain
*Envenomation site: numbness, swelling, ischemia, cyanosis
*Systemic: weakness, sweating, visual changes, muscle paralysis, respiratory failure, cardiovascular collapse, coma 
*Death can occur in 1-5 hours

==Differential Diagnosis<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>==
*[[Anaphylaxis]]
*Cnidaria envenomation
*Sea snake envenomation
*Shellfish envenomation

==Evaluation==
===Workup===
*Due to systemic symptoms CMP, Chest X-ray, EKG are reasonable<ref>Kapil S, Hendriksen S, Cooper JS. Cone Snail Toxicity. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470586/</ref>

===Diagnosis===
*Clinical history

==Management==
*No antivenom available
*ABC's
*Prepare for mechanical ventilation with supportive care
*Most patients will develop a chronic wound at the envenomnation site with ulceration that often requires persistent care.
*Hot water (40C-50C) may provide pain relief based on anecdotal reports

==Disposition==
*ICU if intubated
*No clear information on length of observation

==See Also==


==External Links==


==References==
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