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==Background==
==Background <ref>Hauglid, C., Kiel, J., & Schmidt, A. (2021, April 23). Emergen-Sea Medicine: Overview of Marine Envenomations - Page 8 of 9. ACEP Now.https://www.acepnow.com/wp-content/uploads/2021/08/ACEP_August-2021.pdf</ref>==
[[File:Stone Fish at AQWA SMC2006.jpg|thumb|Stonefish]]
[[File:Stone Fish at AQWA SMC2006.jpg|thumb|Stonefish]]
*Synanceia genus of fish of the family Synanceiidae
*Synanceia genus of fish of the family Synanceiidae
**Venom is dangerous and even fatal to humans (possibly most venomous fish known)
*Found in the coastal regions of the Indo-Pacific.
*Found in the coastal regions of the Indo-Pacific.
*This is a grey fish which possesses multiple venomous spines.
*This is the most venomous fish known, with venom likened to that of a cobra.
** The venom blocks cardiac calcium channels, increases systemic catecholamine release, simultaneously causing diffuse vasodilation and increased tissue destruction which propogates uptake of its own venom.


==Clinical Features==
==Clinical Features==

Revisión del 01:49 1 sep 2021

Background [1]

Stonefish
  • Synanceia genus of fish of the family Synanceiidae
  • Found in the coastal regions of the Indo-Pacific.
  • This is a grey fish which possesses multiple venomous spines.
  • This is the most venomous fish known, with venom likened to that of a cobra.
    • The venom blocks cardiac calcium channels, increases systemic catecholamine release, simultaneously causing diffuse vasodilation and increased tissue destruction which propogates uptake of its own venom.

Clinical Features

Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm from stonefish envenomation.

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

Workup

  • No specific testing available

Diagnosis

  • Clinical diagnosis

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
  • Severe toxicity can be treated with antivenin obtained through poison control

Disposition

See Also

External Links

References

  1. Hauglid, C., Kiel, J., & Schmidt, A. (2021, April 23). Emergen-Sea Medicine: Overview of Marine Envenomations - Page 8 of 9. ACEP Now.https://www.acepnow.com/wp-content/uploads/2021/08/ACEP_August-2021.pdf
  2. *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.