Diferencia entre revisiones de «Sea urchins»
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==Background== | ==Background== | ||
*Sea urchins are marine invertebrate echinoderms | |||
*Anatomy consists of soft viscera surrounded by a hard plated body with protruding spines and pedicellariae | |||
*Around 950 known species and some are venomous | |||
**Nonvenomous species have blunt, rounded spines | |||
**Venomous species have sharp, hollow, thin spines | |||
**Some have pedicellariae with sharp jaws and venom glands | |||
===Mechanism=== | |||
*Nonvenomous spines cause direct trauma | |||
*Venoms are known to contain proteases, hemolysins, steroid glycosides, serotonin, cholinergic substances, and rarely neurotoxins | |||
*Pedicellariae attach to the victim and break off from the urchin, releasing venom for several hours | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC3760923 abd-88-0496-g09.png|thumb|Black sea urchins (''Echinometra lucunter''). Below: spinesin the feet of bathers. Right: hyperkeratotic noduleson the hands of a diver who suffered several injuries caused by black sea urchins (foreign body granuloma).]] | [[File:PMC3760923 abd-88-0496-g09.png|thumb|Black sea urchins (''Echinometra lucunter''). Below: spinesin the feet of bathers. Right: hyperkeratotic noduleson the hands of a diver who suffered several injuries caused by black sea urchins (foreign body granuloma).]] | ||
*Minor to severe pain the the site of the embedded spine | |||
*Venomous spines and pedicellariae generally cause much more severe pain and may be accompanied by systemic signs and symptoms with a significant envenomation including pruritus, nausea, vomiting, abdominal pain, respiratory distress, parasthesias, muscle weakness, and hypotension | |||
*Rarely severe envenomations can lead to death | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis | |||
*Plain films of the injured areas to locate embedded spines | |||
**Evaluate for intraarticular spines | |||
**Ultrasound may be useful if none are seen but radiolucent FB is suspected | |||
**MRI can also locate spines not seen on plain film | |||
==Management== | ==Management== | ||
*Emersion in non-scalding water up to 45°C | |||
*Prompt removal of pedicellariae | |||
*Remove spines/foreign bodies | |||
**If spines are intraarticular or near neurovascular structures they need to be carefully removed in the OR | |||
*Thorough irrigation | |||
*Update tetanus vaccination if needed | |||
*Prophylactic antibiotics for deep puncture wounds | |||
===Complications=== | |||
*Retained spines | |||
*Infection ('''[[Vibrio]]''' species) | |||
*Granuloma and cyst formation | |||
* | |||
==Disposition== | ==Disposition== | ||
*Depends on the extent and location of injury and degree of envenomation | |||
==See Also== | ==See Also== | ||
| Línea 27: | Línea 62: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
1.Auerbach P. Chapter 73. Envenomation by aquatic invertebrates. In: Auerbach P. Wilderness Medicine. | |||
Revisión del 18:14 29 jul 2020
Background
- Sea urchins are marine invertebrate echinoderms
- Anatomy consists of soft viscera surrounded by a hard plated body with protruding spines and pedicellariae
- Around 950 known species and some are venomous
- Nonvenomous species have blunt, rounded spines
- Venomous species have sharp, hollow, thin spines
- Some have pedicellariae with sharp jaws and venom glands
Mechanism
- Nonvenomous spines cause direct trauma
- Venoms are known to contain proteases, hemolysins, steroid glycosides, serotonin, cholinergic substances, and rarely neurotoxins
- Pedicellariae attach to the victim and break off from the urchin, releasing venom for several hours
Clinical Features
- Minor to severe pain the the site of the embedded spine
- Venomous spines and pedicellariae generally cause much more severe pain and may be accompanied by systemic signs and symptoms with a significant envenomation including pruritus, nausea, vomiting, abdominal pain, respiratory distress, parasthesias, muscle weakness, and hypotension
- Rarely severe envenomations can lead to death
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
- Venomous fish
- Cone shell
- Lionfish
- Sea urchins
- Crown-of-Thorns Starfish
- Stonefish
- Other: Catfish, zebrafish, scorpion fish
- Nematocysts
- Coral reef
- Fire coral
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Sea anemones
- Seabather's eruption
- Phylum porifera (sponges)
- Bites
- Infections
Evaluation
- Clinical diagnosis
- Plain films of the injured areas to locate embedded spines
- Evaluate for intraarticular spines
- Ultrasound may be useful if none are seen but radiolucent FB is suspected
- MRI can also locate spines not seen on plain film
Management
- Emersion in non-scalding water up to 45°C
- Prompt removal of pedicellariae
- Remove spines/foreign bodies
- If spines are intraarticular or near neurovascular structures they need to be carefully removed in the OR
- Thorough irrigation
- Update tetanus vaccination if needed
- Prophylactic antibiotics for deep puncture wounds
Complications
- Retained spines
- Infection (Vibrio species)
- Granuloma and cyst formation
Disposition
- Depends on the extent and location of injury and degree of envenomation
See Also
External Links
References
1.Auerbach P. Chapter 73. Envenomation by aquatic invertebrates. In: Auerbach P. Wilderness Medicine.