Stonefish envenomation

Background

Stonefish
  • 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.

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 [1]
  • 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. *Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty. 2016 May 23;16:ic20. PMID: 27298709; PMCID: PMC4892334.