Lionfish envenomation

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Background

  • From the Scorpaenidae family of camouflaged bottom-dwelling fish
  • Fins have spine connected to venom glands which inject venom when agitated
Lionfish.jpg

Clinical Features

  • Local erythema, ecchymosis, swelling
  • Intense, sharp pain
  • Australian stonefish can cause systemic toxicity:
    • Hypotension, tachycardia, arrhythmia, syncope, vomiting, and pulmonary edema
  • Symptoms peak at 60-90 minutes
    • Duration: 1-2 days

Differential Diagnosis

Marine toxins and envenomations

Evaluation

  • Clinical diagnosis, no specific testing available

Management

  • Clean wound, update tetanus, remove retained tissue
  • Immerse extremity in hot water (45 C) for 30-60 minutes
  • Stonefish envenomations with severe toxicity can be treated with antivenin obtained through poison control

Disposition

See Also

References