Diferencia entre revisiones de «Stonefish envenomation»
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** 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. | ** 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 <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:PMC4862076 12995 2016 112 Fig1 HTML.png|thumb|Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm from stonefish envenomation.]] | [[File:PMC4862076 12995 2016 112 Fig1 HTML.png|thumb|Extensive erythema, gross swelling up to the entire index finger, dorsum, and distal third forearm from stonefish envenomation.]] | ||
*Local erythema, ecchymosis, swelling | *Local erythema, ecchymosis, swelling, necrosis | ||
*Intense, sharp pain | *Intense, sharp pain that peaks at 60 minutes but can lasts for days. | ||
*Systemic toxicity: | *Systemic toxicity: | ||
**[[Hypotension]], [[tachycardia]], [[arrhythmia]], [[syncope]], [[vomiting]], and [[pulmonary edema]] | **[[Hypotension]], [[tachycardia]], [[arrhythmia]], [[syncope]], [[vomiting]], [[compartment syndrome]], and [[pulmonary edema]] (cardiogenic) | ||
*Death can occur in as few as 6 hours. | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revisión del 01:52 1 sep 2021
Background [1]
- 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 [2]
- Local erythema, ecchymosis, swelling, necrosis
- Intense, sharp pain that peaks at 60 minutes but can lasts for days.
- Systemic toxicity:
- Hypotension, tachycardia, arrhythmia, syncope, vomiting, compartment syndrome, and pulmonary edema (cardiogenic)
- Death can occur in as few as 6 hours.
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
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 [3]
- 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
- ↑ 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
- ↑ 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
- ↑ *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.