Marine envenomations from corals, sea urchins, fish, or stingrays
- Geoffrey K Isbister, MD
Geoffrey K Isbister, MD
- Professor, Clinical Toxicology Research Group
- University of Newcastle, Australia
- Section Editors
- Daniel F Danzl, MD
Daniel F Danzl, MD
- Section Editor — Environmental Emergencies
- Professor of Emergency Medicine
- University of Louisville School of Medicine
- Stephen J Traub, MD
Stephen J Traub, MD
- Section Editor — Toxicology
- Associate Professor of Emergency Medicine
- Mayo Medical School
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Marine injuries due to corals, sea urchins, fish spines, and stingrays will be reviewed here.
Jellyfish and Portuguese man-of-war stings and marine toxins, such as ciguatera, scombroid, and shellfish poisoning, are discussed separately. (See "Jellyfish stings" and "Overview of shellfish and pufferfish poisoning".)
EPIDEMIOLOGY AND CLINICAL MANIFESTATIONS
The mode of envenomations by coral, sea urchins, venomous fish, and stingrays vary by animal. These envenomations are painful. The degree of pain is largely determined by the amount of venom injected and the animal encountered.
The puncture wounds associated with marine envenomations often have retained foreign bodies and are frequently contaminated. Most wounds are superficial although stingrays can cause deep penetrating injuries.
Coral — Coral are cnidarians, like jellyfish, and members of the class Anthozoa . Coral stings and lacerations are common among snorkelers, surfers, and scuba divers who touch, step, or fall onto coral .
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- EPIDEMIOLOGY AND CLINICAL MANIFESTATIONS
- Sea urchins
- Venomous fish
- DIFFERENTIAL DIAGNOSIS
- Jellyfish and sea anemone stings
- Blue-ringed octopus (Hapalochlaena maculosa)
- Sea snake envenomation
- Cone snail
- Marine skin lesions
- - Swimmer’s itch
- - Seabather’s eruption
- - Stinging sponge dermatitis
- Pain control
- Local wound care
- Antibiotic therapy
- Stonefish antivenom
- SUMMARY AND RECOMMENDATIONS